Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
Search
Advanced search
OR
Browse
Search
Volume 51, Issue 4
Displaying 1-34 of 34 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Contents
  • Risk-management in Pediatric wards
    HIROYUKI KOBAYASHI
    2005 Volume 51 Issue 4 Pages 490-500
    Published: December 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.490
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    In 2003 there were 987 new medical malpractice suits in Japan. The most important issue in medical risk-management is informed consent. Medical and paramedical staff must have fixed protocols detailing what must be discussed and parents/guardians must be confident that they understand what is being explained to them. Sources of risk-management problems in pediatric wards involve misunderstanding between patients and staff, prescription and dispensing of medications, blood transfusions, nosocomial infections, tracheal tubes, injuries in the ward, and informed consent. If such problems can be managed, then there should be fewer medico-legal disputes in Japan.
    View full abstract
    Download PDF (1805K)
  • How to approach mild developmental disorders such as attention deficit hyperactivity disorder (ADHD) and Asperger disorder
    MEGUMI IIJIMA
    2005 Volume 51 Issue 4 Pages 501-508
    Published: December 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.501
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    The concern for mild developmental disorders such as ADHD and Asperger disorder has been increasing in both educational and medical fields. The main problem is that these disabilities are not easy to diagnose, although students attending normal schools have considerable difficulties in communicating with their classmates, following the classroom learning and activities, and coping with their intractable behaviour. For children with mild developmental disorder, intervention at an early stage is very important to prevent secondary emotional disorders and various behavioral problems. Recently, “Special Support Education” has been advanced by the Ministry of Education to support children with mild developmental disorders in Japan. This program provides unique educational support to improve various skills involved in social, academic participation, according to each child's own needs and goals in the normal class It is necessary to immediately establish this practical system to support children with mild developmental disorders in cooperation with various professionals in educational, medical and welfare fields.
    View full abstract
    Download PDF (1101K)
  • The use of probiotics in the prevention and treatment of diseases in children
    SATORU NAGATA
    2005 Volume 51 Issue 4 Pages 509-518
    Published: December 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.509
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Intestinal microflora are established soon after birth and remain almost stable during lifetime. The colonic microbiota plays an important role in host nutrition and health by promoting nutrient supply, preventing pathogen colonization and developing and maintaining normal immunity. Probiotics are defined as living microbial food supplements that beneficially affect the host by improving its intestinal microbial balance. In our previous study, earlier administration of Bifidobacterium breve (B breve) and consequent earlier detection in stools of low birth weight infants, suggesting establishment of normal intestinal flora, contributed to the prevention of infections and necrotizing enterocolitis. In the supplement group, fecal lactate and acetate concentrations were higher in very low birth weight and extremely low birth weight infants, whereas there was no detectable level of butylate. In our subsequent study, serum TGF-β level and smad 4 expression were increased after B breve challenge, while that of smad7 remained weak. Furthermore, we demonstrated that B breve induced proliferation of repopulated circulating NK cells after chemotherapy in children with malignant diseases. To expand the clinical applications of probiotics throughout the world, further randomized control studies on a massive scale are clearly needed.
    View full abstract
    Download PDF (1513K)
  • Outpatient or home chemotherapy for advanced or recurrent colorectal cancer
    --Usefulness of continuous infusion of 5FU with bolus CDDP via subcutaneous implantable reservoir--
    MUTSUMI SAKURADA, MASANOBU TANAKA, YOSHIRO ISHIBIKI, SHUUICHI SAKAMOTO ...
    2005 Volume 51 Issue 4 Pages 519-527
    Published: December 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.519
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : Low-dose 5FU with CDDP therapy was applied to unresectable or recurrent colorectal cancer patients via subcutaneous implantable reservoir. The effectiveness of this treatment was evaluated. Materials and Methods : Twenty-three patients with unresectable or advanced colorectal cancer were analyzed. All patients continued to receive low-dose FP therapy (5FU300mg/m2/d, civ, dl-5 + CDDP 7mg/ m2/ d, iv, dl&4) until Progressive Disease or the appearance of the significant toxicity. The following items were analyzed. Efficacy, survival period, ratio of home treatment period (period at home/period of survival), safety, medical cost and responses to a questionnaire survey of the patients about QOL.. Results : The rate of effectiveness was 17%. In total, 83% of the patients did not show any serious clinical side effects prior to Progressive Disease. The average interval until Progressive Disease was 8 months. The ratio of home treatment period was 75 %. The following toxicities were observed. : pigmentation of fingers (11 cases), cheilosis, aphtha (5 cases) nausea, vomiting (3 cases) leucocytopenia, grade 2 (10 cases). The toxicities described above were not severe. Catheter problems were observed in 7 cases. One case required the exchange of the reservoir. Medical cost of outpatient or home chemotherapy ranged from one-fourth to one-fifth of the cost of in-hospital chemotherapy. Conclusion : We concluded that outpatient or home chemotherapy with reservoir can be applied to patients safely and reliably and was also useful for improving patient QOL and reducing medical expenses.
    View full abstract
    Download PDF (2274K)
  • Relationship between stromal fibrosis and distant metastasis in patients with mp colorectal cancer
    MAKOTO TAKAHASHI, MASAKAZU OOUCHI, YUKIHIRO YAGINUMA, YASUNORI ISHIDO, ...
    2005 Volume 51 Issue 4 Pages 528-533
    Published: December 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.528
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : Although colorectal cancer invading the proper muscle (mp colorectal cancer) is an advanced form of cancer, it has a relatively good prognosis. However, there is a subgroup of patients with mp colorectal cancer who develop distant metastases and show a poor prognosis. We have examined the characteristics of such metastatic mp colorectal cancers from the perspective of stromal fibrosis. Materials : Seventy-eight patients with mp colorectal cancer who underwent surgery in our hospital between 1996 and 2002. Methods : Distribution of myofibroblast was determined as stromal fibrotic region by immunohistochemistry with α- smooth muscle actin (SMA), desmin and CD34. The area of stromal fibrosis was quantified using an image analyzer, and the fibrosis ratio to tumor area was calculated. Results : Distant metastases from mp colorectal cancer were found in 8 patients (8/78, 10.2%. The fibrotic area of the distant metastasis group was 16.2±9.6mm2, and that of the non-metastasis group was 14.0±9.0mm2, showing no significant difference between groups. The fibrosis ratio of the distant metastasis group was 22.9 ± 8.0%, which was significantly higher than that of the non-metastasis group (17.3±7.5% ; p=0.043). Conclusions : The fibrosis ratio of the distant metastasis group in mp colorectal cancer was higher than that of the non-metastasis group, suggesting that the fibrosis ratio of stromal fibrosis in colorectal cancer may be available as an index for poor prognosis in mp colorectal cancer.
    View full abstract
    Download PDF (1030K)
  • The comparative genomic hybridization analysis of chromosomal aberrations related to lymph node metastasis of colorectal cancer.
    YASUNORI ISHIDO, JO UNOTORO, HIROHIKO KAMIYAMA, YUKIHIRO YAGINUMA, SHI ...
    2005 Volume 51 Issue 4 Pages 534-539
    Published: December 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.534
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective: We examined the DNA copy number profiles of colorectal cancer (CRC) by comparative genomic hybridization (CGH) in order to identify the gene related to lymph node metastasis. Materials: We reviewed 46 CRC patients who underwent surgical resection at our department between April 2003 and December 2004. Of those patients, 30 patients showed lymph node metastasis and 16 patients were without lymph node metastasis. Method: We extracted chromosomal DNA, by microdissection, from primary carcinomas that had been surgically removed then immediately frozen. We then compared the DNA copy number profiles between two groups. Results: Significant differences (p<0.05) in copy number gains between patients with lymph node metastasis and patients without lymph node metastasis were found at 8p23, 8p22, 16q23 (without>with lymph node metastasis) and 5p12 (with>without lymph node metastasis). Significant difference in copy number losses was found at 5q13 (with>without lymph node metastasis). Conclusions: There is a possibility that a gene related to lymph node metastasis exists in CRC patients and involves 5p12, 8p23, 8p22, 16g23, 5q13.
    View full abstract
    Download PDF (959K)
  • Glomerular IgA deposition through Th2-dominant mucosal immune responses
    TAKAHIRO YAMANAKA, HIDEKAZU TAMAUCHI, YUSUKE SUZUKI, SATOSHI HORIKOSHI ...
    2005 Volume 51 Issue 4 Pages 540-547
    Published: December 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.540
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective: The Th1/Th2 balance paradigm is considered related to the pathogenesis of IgA nephropathy. The present study investigated the mechanism of glomerular IgA deposition via mucosal immunity in several kinds of GATA-3 transgenic (GATA-3 Tg) mice, which have a Th2-dominant immunological background. Materials: The hemizygous GATA-3 Tg mice were crossed with the homozygous type of another transgenic (TCR-Tg) mouse for T cell receptor (TCR) recognizing OVA323-339 peptide in the context of I-Ad restriction. GATA-3/TCR-Tg and non-GATA-3 (WT) /TCR-Tg mice were generated by this method. Methods: Cholera enterotoxin (CT) was used as a mucosal adjuvant for Th2-dominant immune responses in oral immunization. Alum was used as an adjuvant for general immunopotentitation in intraperitoneal immunization. GATA-3/TCR-Tg mice and WT/TCR-Tg mice were orally preimmunized with OVA and CT or CT alone. The animals were orally immunized with OVA for 7 days after the final immunization. The levels of serum OVA-specific IgA antibody, urinary albumin and creatinine excretion and histopathological analysis of the kidney and intestine were examined. Measurement and Results : Only GATA-3/TCR-Tg mice that were orally immunized with OVA and CT showed mesangial proliferation with IgA/C3 depositions, the elevation of serum levels of OVA-specific IgA antibody, glomerular MBL deposition colocalized with IgA, and IgG2a deposition. These findings closely resemble clinical findings in human IgA nephropathy. Conclusions: The present data indicate that Th2-dependent mucosal immune responses may lead to glomerular IgA deposition, presumably through aberrant glycosylation of IgA.
    View full abstract
    Download PDF (1216K)
  • Effect of Tranilast on chlorhexidine gluconate (CH) -induced sclerosing peritonitis in a mouse model
    MASANORI INABACH, IEKO HAMADA, YUUKI RO, HIROAKI IO, ICHIRO KOYANAGI, ...
    2005 Volume 51 Issue 4 Pages 548-556
    Published: December 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.548
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective: Encapsulating peritoneal sclerosis is a common complication in long-term peritoneal dialysis patients. Peritoneal fibrotic thickening is closely related to decreased ultrafiltration. Several growth factors might induce peritoneal fibrosis. Tranilast, an inhibitor of chemical mediator release, attenuates myocardial and skin fibrosis. The present study investigated whether Tranilast affects the development of peritoneal fibrosis and inhibits cytokine release in a CH-induced sclerosing peritonitis mouse model. Material: C57B06CrSlc mice were given intraperitoneal injections of 0.2ml/20g body weight (BW) of 0.1 % chlorhexidine gluconate for 21 days every other day (CH group). Some CH mice were alternately administered 6mg/20g BW of Tranilast by intraperitoneal injection (CH+Tranilast group). These mice were sacrificed on days 7, 14 or 21 after the injection. Method: Parietal peritoneum was analyzed by light microscopy. Immunohistochemical staining was performed using anti-vimentin, anti-cytokeratin PAN and anti-hepatocyte growth factor (HGF) antibodies. The mRNA expressions of transforming growth factor-β1 (TGF-β1) and Type-III collagen were determined by semi-quantitative RT-PCR. Result: Thickening of the submesothelial compact zone gradually increased in the CH group. In the CH+Tranilast group, the increase of this zone was markedly suppressed until day 14 and HGF positive cells were observed in the superficial layer until day 14. Furthermore, mRNA expressions of TGF-β1 and Type-III. collagen were suppressed in the CH+Tranilast group until day 14. But thickening of the submesothelial compact zone and mRNA expression of Type-III collagen increased at day 21. Conclusion: It appears that Tranilast might delay the development of peritoneal fibrosis by suppression of TGF-β1 and maintenance of peritoneal mesothelial cells in the CH-induced sclerosing peritonitis mouse model.
    View full abstract
    Download PDF (1822K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top