Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
Search
Advanced search
OR
Browse
Search
Volume 50, Issue 1
Displaying 1-17 of 17 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Contents
  • Natural antibody-mediated graft rejection in xenotransplantation
    TOSHIYADU KAWAHARA
    2004 Volume 50 Issue 1 Pages 2-8
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.2
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Recently, the shortage of donor organs shortage for transplantation has become a serious problem, paradoxically, because of the success of transplantation. Xenotransplantation is one of the potential solutions for this organ shortage. However, grafts meet with hyperacute rejection (HAR) immediately after transplantation in pig-to-primate species combinations due to anti-Gal natural antibody against the carbohydrate epitope, Galα1, 3Galα1-4GlcNAc-R (αGal) on the vascular endothelium of the xenograft. We demonstrated that peritoneal cavity B cells can become anti-Gal-producing cells in the spleen, and that this is associated with down-regulation of Mac-1. Thus, peritoneal cavity Mac-1+B cells may be precursors of Mac-1-splenic anti-Gal-producing cells. Therefore, splenectomy of recipients may be an effective treatment in xenotransplantation and may contribute to the clinical applicbility of xenotransplantaion.
    View full abstract
    Download PDF (980K)
  • Role of leptin in progression of alcoholic and non-alcoholic steatohepatitis
    KENICHI IKEJIMA
    2004 Volume 50 Issue 1 Pages 9-16
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.9
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Accumulating lines of evidence suggest that alcoholic liver disease (ALD) and non-alcoholic steatohepatitis (NASH) share a common patho-physiological basis in terms of inflammation and fibrogenesis. It is well known that NASH is accompanied by metabolic syndrome comprising obesity, type-2 diabetes and hypertension. In addition, recent epidemiological studies have revealed that obesity is an important risk factor in progression of ALD. It is hypothesized that adipocytokines, insulin resistance and autonomic nervous regulation play causative roles in the disease progression of ALD and NASH. In this study, therefore, we focused on the role of leptin in inflammation and fibrogenesis in the liver. Activated hepatic stellate cells (HSCs) produce leptin during hepatic fibrogenesis. Xenobiotic-induced liver fibrosis was extremely diminished in ob/ob mice and Zucker (fa/fa) rats, inborn leptin-and leptin receptor (Ob-R) -deficient animals, respectively. Further, leptin increased TGF-β mRNA in isolated sinusoidal endothelial cells and Kupffer cells. Moreover, leptin augmented PDGF-dependent proliferation of HSCs. Taken together, it is postulated that leptin acts as a profibrogenic cytokine in sinusoidal microenvironment. In conclusion, leptin most likely plays a pivotal role in the progression of hepatic fibrosis in ALD and NASH.
    View full abstract
    Download PDF (1423K)
  • Mobilization of hematopoietic stem cells from bone marrow into peripheral blood
    KOICHI HATTORI
    2004 Volume 50 Issue 1 Pages 17-25
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.17
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    In adults, stem cells are localized within the bone marrow (BM) microenvironment, where they exist in either a quiescent state or are instructed to proliferate, differentiate and mobilize to the circulation following specific physiological stresses. However, the mechanism for the recruitment of such stem cells as endothelial and hematopoietic stem cells (HSCs) from the BM microenvironment is not known. We show that matrix metalloproteinase-9 (MMP-9), induced in BM stromal cells, is the key factor in releasing soluble Kit-ligand (sKit-1) enabling the transfer of stem cells from the quiescent to the proliferative niche. Administration of cell mobilizing factors including not only hematopoietic growth factors but also angiogenetic factors or chemokines results in upregulating MMP-9 expression, which then causes shedding of sKit-1 and recruitment of stem cells. In MMP-9-/-mice, release of sKit-1, cell cycling and motility of HSCs is profoundly impaired, resulting in failure in hematopoietic recovery and increased mortality after BM suppression. Exogenous sKit-1 restores hematopoiesis and survival of BM ablated MMP-9-/-mice. Thus, release of sKit-1 by MMP-9 in response to stress enables HSCs to translocate to a permissive niche favoring proliferation, differentiation, mobilization and reconstitution of the stem cell pool.
    View full abstract
    Download PDF (1951K)
  • Optimization of voluntary movements in the cerebellum
    SHIGERU KITAZAWA
    2004 Volume 50 Issue 1 Pages 26-33
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.26
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Voluntary goal-directed movements, such as arm reaching, are nearly optimized in terms of smoothness over the entire movement. Such smoothness is lost with cerebellar dysfunction, suggesting the essential role of the cerebellum in optimizing movement. However, it is still not clear how the cerebellum contributes to achieving this smoothness over an entire movement. A recent study3 has shown that such smoothness of movement can be achieved by reducing the variance of errors at the end of the movement. The author proposes a novel hypothesis that the terminal errors conveyed by climbing fibers in the cerebellum4 serve to reduce not only the mean error, but also the variance of the error, through a process analogous to the random walk through movement control candidates. The validity of the hypothesis will be tested by constructing an artificial cerebellum that follows the principles of the random walk hypothesis.
    View full abstract
    Download PDF (1380K)
  • Advances in ophthalmic surgery
    AKIRA MURAKAMI
    2004 Volume 50 Issue 1 Pages 34-40
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.34
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Recent improvements in ocular surgical techniques have greatly reduced the incidence of complications. In cataract surgery, advances in techniques and equipment have led to a dramatic increase in the application of phacoemulsification with increased safety and efficiency. Viscoelastic agents have been developed synchronously with phacoemulsification techniques, playing an integral role in the success of this new technology. Vital dyes and surgical adjuvants have been reported effective in staining intraocular tissues to facilitate the identification and removal of these tissues during surgery. Because an otherwise highly challenging surgical step became relatively easy, the use of these materials was quickly and widely adopted. The purpose of this article is to provide an overview of the advancement in intraocular lenses and applicable surgical adjuvants and their proper use.
    View full abstract
    Download PDF (1220K)
  • Liver transplantation
    SEIJI KAWASAKI
    2004 Volume 50 Issue 1 Pages 41-47
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.41
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Partial liver, split liver, and living donor liver transplantation (LDLT) have been developed in response to the scarcity of pediatric donor organs from cadavers in Western countries, and adultto-adult LDLTs using right lobar graft have become increasingly popular in recent years. In Japan, more than 2,000 LDLTs have been performed in both pediatric and adult patients using various types of liver graft such as left and right lobar grafts, while only about 20 cadaveric liver transplantations have been carried out in the past 6 years. In LDLT, several donor deaths have been reported in western countries, but in Japan no donor death had been documented until January 2003, when one donor died of liver failure after right lobectomy. Donor safety needs to be further discussed based on accurate information on the donor's outcome in this innovative treatment.
    View full abstract
    Download PDF (1005K)
  • MRSA, new topics
    NANAE ARITAKA, SATOSHI HORI
    2004 Volume 50 Issue 1 Pages 48-59
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.48
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Staphylococcus aureus (S. aureus) has acquired antimicrobial resistance to various kinds of antibiotics, after acquired rapidly after new antibiotics become available for clinical use. To date, MRSA has been known as the most important pathogen of hospital infection. Vancomycin (VCM) has been used as the drug of choice for MRSA infection in the past 20 years, however, the first low level vancomycin-resistant S. aureus (L-VRSA) strain was isolated in 1997 in Japan. L-VRSA is defined as an S. aureus strain with a MIC of more than 8μg/ml to VCM and L-VRSA strains have been widely reported in various countries since 1997. The level of resistance of L-VRSA is high enough to survive the treatment of MRSA infection with VCM. Moreover, a VRSA strain with a higher level of VCM resistance was isolated in the United States in 2002. This strain is speculated to acquire VCM resistance genes from VCM-resistant enterococci that were simultaneously isolated from identical infected sites in patients. From the beginning of the 1990's, increased incidence of community-acquired MRSA (C-MR-SA) has been observed in the United States, Europe and Australia. Although C-MRSA strains tend to be susceptible to various kinds of antibiotics except for β-lactam types, it was found that various virulent factors such as toxins are expressed from C-MRSA strains. These toxins may be associated with the high mortality of C-MRSA infections. In 2001, whole genome sequences of several MRSA strains, including VRSA and C-MRSA, were determined. This is expected to elucidate the mechanism of VCM resistance and C-MRSA-specific pathogenicities. It is recommended that VCM monotherapy, combination therapy of VCM with rifampicin and/or co-trimoxazole, teicoplanin with β-lactam antibiotics, sulbactam/ampicillin and arbekacin be used for MRSA infections. Proper antibiotic use is also important as an effective and established preventive measure for hospital infections.
    View full abstract
    Download PDF (2217K)
  • Intrahospital emergency system and ACLS from a viewpoint of risk management
    TETSU OKUMURA, HIROYUKI KOBAYASHI, HIDEHIKO HISAOKA
    2004 Volume 50 Issue 1 Pages 60-67
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.60
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    As public awareness of medical care increases, the quality of first aid systems in hospitals becomes increasingly important. Substantiality of the first aid system in hospital is urgent business for all hospitals at now that civic medical knowledge become very popular and precise. Policies regarding the quality of the first aid systems in hospitals from the viewpoint of risk management are discussed in this report by introducing the procedures of this hospital. Components of our system are as follows : 1) ACLS (Advanced Cardiovascular Life Support), 2) Emergency call system, 3) AED (automated external defibrillators), 4) Unification of Contrast media allergy treatment in hospital. In addition, problems to be addressed in the future are also discussed.
    View full abstract
    Download PDF (967K)
  • Genotypic Resistance Assay to Antiretrovirals in HIV-1 Infected Individuals
    MASAZUMI YAMAGUCHI, TOSHIO NAITO, HIROSHI ISONUMA, TAKAO MATSUMOTO, TA ...
    2004 Volume 50 Issue 1 Pages 68-76
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.68
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Background : Occurrence of antiretrovirals-resistant HIV-1 raises public health concerns in North America and Europe. Objective : To investigate genotypic resistance to antiretrovirals in HIV-1 infected individuals. Patients : Ten HIV-1-infected patients who received treatment between February 2003 and October 2003 at Juntendo University Hospital. Method : Genotypic HIV-1 resistance assay using RT-PCR and direct sequencing. Results : Three of 5 patients on therapy had resistance-associated mutations for NRTIs (D67N, K70R, M184V, T215N/V and/or K219Q), 1 had mutations for NNRTIs (K103N and V108I) and 2 had them for PIs (D30N or I84V). Two of the subjects showed resistance to two or more classes of antiretrovirals. NRTI-resistant patients tended to have a longer history of NRTI treatment, although it was not statistically significant. Two of 5 naïve patients had resistance for NRTIs (T215E) and 1 showd resistance for NNRTIs (G190A). Conclusions : Our study suggests that it is important for patients receiving treatment for a long period, those with detectable viral load, and those intending to start treatment to be tested by assay for resistance to antiretrovirals.
    View full abstract
    Download PDF (1267K)
  • Immunohistochemical Study of Chromogranine A and Serotonin as Markers of Neuroendocrine cell Distribution in Intestinal Neuronal Dysplasia.
    TAKASHI KUGA, AKIKO KOBAYASHI, HIROYUKI KOBAYASHI, ATSUYUKI YAMATAKA, ...
    2004 Volume 50 Issue 1 Pages 77-83
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.77
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : We investigated the distribution of neuroendocrine (NE) cells in rectal and large bowel mucosa from patients with isolated intestinal neuronal dysplasia (IND group) and Hirschsprung's Disease (HD) complicated by IND (HD/IND group) to improve understanding of the etiology of IND. Materials : Rectal biopsy specimens from eight patients with IND (mean age : 5.4+2.3 years, 4 male, 4 female) and resected surgical specimens from seven patients with HD/IND (mean age : 3.5+2.9 years, 4 male, 3 female) treated in our unit between 1 January 1995 and 31 December 2001 were the subjects of this study. Twenty patients who underwent bowel resection for conditions unrelated to bowel motility disorders acted as controls. Methods : Immunohistochemistry using avidine-biotinilated complex and monoclonal antibodies to chromogranine A (ChA) and serotonin (5HT) were used to compare the distribution of NE cells in bowel specimens. HD/IND specimens were further subdivided into aganglionic, transitional, and IND segments. NE cells were counted under light microscopy. Tests for significant differences between groups were performed using Student's t-test. Results : ChA immunoreactive cells were increased in IND (3.35+0.56) compared with controls (0.87+0.26) (p<0.01). 5HT immunoreactive cells were also increased in IND (2.78+ 0.29) compared with controls (0.25+0.05) (p <0.01). There was an increase in the number of ChA and 5HT immunoreactive cells in both aganglionic (ChA : 3.25+0.28, 5HT : 2.78+.34 and transitional (ChA : 2.67+0.32, 5HT : 2.01+0.24) segments of HD/IND compared with controls (p<0.01). Interestingly, immunostaining for ChA (5.23+1.25) and 5HT (4.23+0.56) in IND segments of HD/IND was significantly higher than in the aganglionic segment (p<0.05). Conclusion : There was a consistent increase in mucosal NE cells in segments of bowel with typical histopathologic features of IND. The results suggest that an increase in mucosal NE cells may cause abnormal neuronal histopathology such as giant ganglia and hyperganglionosis and play a role in regulating contraction of the intestine in IND.
    View full abstract
    Download PDF (1689K)
  • The effects of combination chemotherapy (5-fluorouracil and cisplatin) on elderly patients with unresectable advanced gastric cancer
    KOICHI KASHIWAKURA, RYOZO IWAZAKI, NOBUKO SERIZAWA, TATSUYORI IIJIMA, ...
    2004 Volume 50 Issue 1 Pages 84-91
    Published: March 31, 2004
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.50.84
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : This study was performed to investigate whether chemotherapy is effective for unresectable advanced gastric cancer in elderly patients over 70 years old. Subjects and methods : The Subjects were 19 patients over 70 years old and 55 patients under 70 years old who received combination chemotherapy at our department over the past 12 years. The elderly group consisted of 15 males and 4 females with a mean age of 75.1 years, ranging from 70 to 79. The younger group consisted of 40 males and 15 females with a mean age of 55.0 years, ranging from 21 to 69. They were treated with a combination of 5-fluorouracil and cisplatin (CDDP) alone or with addition of mitomycinC (MMC), etoposide (VP16), leucovorin (LV) or irinotecan hydrochloride (CPT11), and evaluated for efficacy rate, median survival time (MST), average number of days residing at home, residing at home for over 50 % of their survival time, and improvement of P. S. Result : The systemic therapies for the elderly group of patients were effective in 4 out of 19 cases [21.1%, Complete Response (CR); 1, Partial Response (PR); 3, Minimal Response (MR); 5, No Change (NC); 9, Progressive Disease (PD); 1], while for the younger patients therapy was effective in 14 out of 55 cases [25.5 %, CR; 1, PR; 13, MR; 5, NC; 23, PD; 13]. The MST of the elderly group was 272.0 days, compared to 208.0 days for the younger group. The average number of days residing at home for the elderly group was 194.9 days, while for the younger group it was 136.2 days. Ten (52.6%) of the elderly patitnts resided at home for over 50 % of their survival time, and 19 (34.5%) did so in the younger group. Improvement of performance status (P.5) was found in 14 subjects (73.4%) in the elderly group, and 31 (56.3%) in the younger group. Observed side effects for the elderly group were leukopenia in 8 cases (42.1%), thrombocytopenia in 2 cases (10.5%), anemia in 1 case (5.3%) and nausea or vomiting in 0 cases (0%). For the younger group leukopenia was seen in 3 cases (5.5%, thrombocytopenia in 3 cases (5.5%), anemia in 1 case (1.9%), and nausea or vomiting in 5 cases (9.1%). They were all classified as grade 3 side effects. Conclusion : These result suggested that chemotherapy for the elderly group with unresectable advanced gastric cancer was more effective than for the younger group, because the improvement of quality of life (QOL) for the elderly group was recognized in comparison of the average number of days residing at home, residing at home for over 50 % of survival time, and improvement of P. S.
    View full abstract
    Download PDF (1186K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top