Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 51, Issue 2
Displaying 1-25 of 25 articles from this issue
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Contents
  • The relics of ancient medicine in the Mediterranean world ; Asclepian worship and Hippocrates
    REITARO IKEDA
    2005 Volume 51 Issue 2 Pages 104-113
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.104
    JOURNAL FREE ACCESS
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    The familiar emblem of medical schools shows a winged staff with two snakes entwined around it. The significance and historical background of this design may be explaind by analyzing a bas-relief called “Hermes of Samos”. The relief presents a huge serpent to receive three worshippers sitting on a rock with a staff at its foot. The staff is a typical attribute of Hermes as herald of the Olympian gods. Snakes, feared and revered in the ancient world because of their poisonous and tenacious vitality, were believed to have an ability to communicating with the underworld. Asclepius was worshipped in the ancient world as a medical deity and had many shrines over the Mediterranean area. He was represented as a thoughtful man leaning upon a staff with a serpent clinging to it, which suggests that the god himself might embody the healing power of snakes. Hippocrates was a member of the priesthood that served in a famous shrine and medical center on the island of Cos. He had accumulated medical knowledge and experience during this service which enabled him to edit a huge corpus of medical works. The emblem of medical schools must have resulted from confusion between Hermes and Asclepius, since both gods were assoclated with snakes.
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  • Review of forty years of studies on Ca2+ homeostasis in myocytes
    YASUO OGAWA
    2005 Volume 51 Issue 2 Pages 114-122
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.114
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    The free Ca2+ concentration in the sarcoplasm is about 0.1 μM at rest, whereas the extracellular Ca2+ concentration is about 1 mM. Activation of myocytes causes a transient increase of the sarcoplasmic Ca2+ to several μM, resulting in triggered activities including muscle contraction. Here, I first review our achievements in characterization of Ca2+ buffers (EGTA, Ca2+ dyes, troponin C, calmodulin and parvalbumins) with the implications of those results. Then, the transient kinetics of Ca2+ pump and EP formation are discussed in reference to the rate of muscle relaxation. Finally, our recent studies on the properties of ryanodine receptor isoforms (Ca2+ releasing channels) are described. The gain for CICR of RyR1 is suppressed in the SR from wildtype animals, whereas the suppression is absent in the mutant expressing the malignant hyperthermia. A minor contribution of CICR to EC coupling is shown in skeletal muscles, and a new approach with line-scan imaging of a multicellular system of a papillary muscle has proved to be effective for elucidation of the mechanisms underlying ventricular arrhythmia.
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  • Learning of clinical medicine from inflammatory connectie tissue diseases
    -focussing on intractable diseases in inflammatory connective tissue diseases-
    HIROSHI HASHIMOTO
    2005 Volume 51 Issue 2 Pages 123-135
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.123
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    The prognosis of inflammatory connective tissue diseases, especially systemic lupus erythematosus SLE, has improved dramatically over the past quarter century because diagnostic and therapeutic measures for these diseases have developed rapidly. However, intractable diseases such as diffuse proliferative lupus nephritis, organic brain syndrome in lupus, catastrophic anti-phospholipid syndrome, anti-neutrophil cytoplasmic antibody (ANCA) -related vasculitis. and other conditions, still exist. Furthermore, the incidence of complications such as infection, atherosclerosis, osteoporosis and malignancies is increasing with prolongation of patients' lives. Further improvement in the prognosis and QOL will be achieved, if intractable inflammatory connective tissue diseases can be successfully treated and complications can be prevented.
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  • My Senior Doctors and their Words
    HIDEO UENO
    2005 Volume 51 Issue 2 Pages 136
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.136
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    My unforgettable words which I heard from my respectful senior doctors were described.
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  • Immunohistochemical study of proteins related to the pathophysiology of Alzheimer's disease in the human retina of elderly patients without dementia.
    LIMEI LI, TADASHI TAKAHASHI, SHINJI NAKAMURA, AKIRA MURAKAMI, HEII AR ...
    2005 Volume 51 Issue 2 Pages 137-146
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.137
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    Objective: The pathological features of Alzheimer's disease (AD) include neuritic plaques (NP) composed of amyloid-beta peptide (Aβ) fibrils, neurofibrillary tangles (NFT) of hyperphosphorylated Tau, and neurotransmitter deficits. Human retinal synapses directly associate with the central nervous system (CNS) through the optic nerve, and the bilateral optic nerves are both derived from the same origin, neural ectoderm. Therefore, it is possible that there would be neuropathological changes in the retina of AD patients similar to those in the CNS. As there are age-related changes observed in the retina, it would be important to investigate the location of proteins related to the neurodegeneration and pathophysiology of AD in the retina. In this study, we investigated the existence and expression pattern of AD-related neuropathological changes in the retina and optic nerve of elderly patients without dementia. Subjects and methods: Retinal samples of six individuals without dementia were obtained from the eye bank of Juntendo University hospital. The mean age ± SD was 68.3±6.1 years. By immunohistochemical analysis, the presence of ten kinds of proteins related to neurodegeneration and AD pathology (advanced glycation end-products, cathepsin D, amyloid β-precursor protein, ubiquitin, calretinin, nitrotyrosine, α-synuclein, PHF-Tau, Tau, single stranded DNA5) were detected using separate antibodies. Results: We found that PHF-Tau, an important component of amyloid β-precursor protein and a major component of NP and NFT, was strongly expressed in the retina except for single-stranded DNA. Other proteins also showed medium to strong signals with particular patterns. Conclusion: These findings demonstrate for the first time the location of proteins related to AD in the retina of elderly patients without dementia, indicating a relationship between the aging process and neurodegeneration in the human retina. Further neuropathological studies of the retina from both young patients without dementia and patients with AD should be investigated in the future.
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  • Clinicopathological Features in Thymoma-Associated Autoimmune disease
    SATOSHI SONOBE, HIDEAKI MIYAMOTO, HIROSHI IZUMI, TOSHIRO FUTAGAWA, YOU ...
    2005 Volume 51 Issue 2 Pages 147-152
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.147
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    Objectives: The WHO classification of thymic epithelial neoplasms was published by Rosai et al. in 1999, leading to a tentative standardization. There have only been a few reports about the usefulness of the WHO classification for thymoma in patients with concomitant autoimmune disease. The prognosis of typical thymoma in patients with concurrent autoimmune diseases was assessed based on the WHO classification in the present study. Subjects : Of 100 patients with thymic epithelial neoplasms that were surgically removed at our department between October 1983 and February 2002, 97 were included in this study. The three excluded patients had thymic cancer. The other 97 patients included 57 men and 40 women, ranging from 19 to 76 years old (mean: 50.8 years). Fifty-six patients had concurrent myasthenia gravis (MG), 4 had pure red cell aplasia (PRCA), and 1 had hypogammaglobulinemia. Methods : The 97 thymoma patients were divided into groups based on their concurrent autoimmune diseases and the WHO classification of their tumors. Then the survival rate of the 56 and 41 patients with or without MG, respectively, as well as the 4 and 93 patients with or without PRCA, was compared retrospectively. Results: MG was frequently associated with WHO type B1, B2, or B3 thymomas. According to the Masaoka staging system, the mean stage of thymomas associated with MG was 1.79, while the mean stage of thymomas without MG was 1.37.Among the 4 thymomas associated with PRCA, one was type AB, one was type B2, and two were type B3.The 56 patients who had thymomas associated with MG did not show a significant difference in survival from the 41 patients who had thymoma without MG (P=0.4240). However, there was a significant difference in survival between the 4 patients who had thymoma associated with PRCA. and the 93 patients without PRCA (P=0.0030). Conclusion: MG was common in patients with WHO type B1, B2, or B3 thymomas. The presence of MG had no significant influence on survival relative to that of thymoma patients without MG. The survival of patients who had thymoma with concurrent PRCA was significantly worse than that of patients without concurrent PRCA.
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  • Effects of aging and regular exercise on the visual functions.
    MITSURU NAKAMURA, MINORU TANAKA, DAISUKE KUDOU
    2005 Volume 51 Issue 2 Pages 153-159
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.153
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    Objective: Effects of regular exercise (kendo) on eight visual functions were examined in different age groups. Materials and methods: Healthy male volunteers who took regular exercise (more than 1 hour of practice more than 3 times/week; n=30) or who took no exercise (n=30) were subdivided to 3 groups according to their age, i. e., young group (21.0±0.6years old and 13.5±1.7 years' experience of kendo group, and 20.9±1.1 years old for no exercise group, respectively; n=10 each), middle aged group (41.1±1.7 years old and 32.0±2.4 years' experience of kendo group, and 41.1±4.2 years old, respectively ; n=10 each) and older aged group (63.3±2.1 and 49.2±1.1 years' experience of kendo group, and 64.2±2.5 years old, respectively; n=10 each). The following visual functions were measured ; static visual acuity, kinetic visual acuity, dynamic visual acuity, contrast sensitivity, depth perception, ocular motor skill, visual reaction time and eye/hand coordination. Results: We found no effects of aging and regular exercise on contrast sensitivity, ocular motor skill or visual reaction time, while kinetic visual acuity and depth perception declined significantly with age. Contrast sensitivity fell with age, but was strongly correlated with static visual acuity. Similarly, dynamic visual acuity and eye /hand coordination declined with aging, but the reduction was significantly less in the regular exercise groups than in age matched, no exercise groups. Conclusions : Although dynamic visual acuity and depth perception decline with age, the results suggest the possibility that regular exercise, especially kendo, can slow down the speed of the decline.
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  • Induction of heat-shock protein 72 expression by blood flow limit in a rat model of skeletal musclar myopachynsis
    SHOUYU XU, HISASHI NAITOU, SYUNJI TAKAZAWA, HIROSHI IKEDA, HISASHI KUR ...
    2005 Volume 51 Issue 2 Pages 160-166
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.160
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    Objective: To determine whether skeletal musclar myopachynsis was caused by ischemia, we investigated the mechanism of skeletal musclar myopachynsis by examining the gene and protein expressions in muscle tissue. Materials and methods : First of all, using SD rats, we established of a model soleus musclar myopachynsis by removing the gastrocnemius and plantaris in the same hind leg. The right hind leg of the rats was then used in this study. Male rats (8weeks old) were assigned to one of four experimental groups (n=6/group), 1) sedentary control (Con), 2) gastrocnemius and plantaris removed to establish soleus muscular myopachynsis (Op), 3) ischemia for 30minutes (RBF), or 4) Op+RBF. Ischemia was induced by limiting blood flow to the right hind leg with a rubber band four times with in two weeks. Twenty-four hours after the last ischemic episode, the animals were sacrificed, and the soleus muscles were removed and weighed, then the sectional area of myofibrillars and the relative levels of HSP72 were measured. Results: On comparison among Con and Op or RBF animals and among OP or RBF and OP+RBF animals, the relative HSP72 concentration in the soleus muscle was significantly higher. Although ischemia or removal of the gastrocnemius and plantaris resulted in musclar myopachynsis. In Op, RBF and Op+RBF animals, muscle weight and the sectional area of myofibrillars were both significantly elevated. Conclusions : These data demonstrate that the level of HSP72 expression was enhanced with skeletal musclar myopachynsis. It was shown that musclar myopachynsis was also caused by ischemia.
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  • An analysis of the 215patients with fever of unknown origin
    HIROKO OHSHIMA, TOSHIO NAITO, JUNKO KUKINO, YUKIKO FUKUDA, NAOHARU SAK ...
    2005 Volume 51 Issue 2 Pages 167-173
    Published: June 30, 2005
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.51.167
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    Objective: Idiopathic fever is one of the symptoms for which it is difficult to determine which department should treat the patient. We analyzed and reviewed the characteristics of 215 patients with idiopathic fever who required hospitalization after their first visits to the Department of General Medicine, Juntendo University School of Medicine, in order to obtain useful information to facilitate diagnosis of future cases. Subjects and methodology: The subjects were 215 adult patients with idiopathic fever who required hospitalization for treatment after an initial visit to our department, between October 1994 and August 2004. We classified the causes of fever by disease that was eventually diagnosed. We also compared the elderly population aged 65 or older and the younger population under 65 years in terms of causal diseases. Results: The causal diseases were infections (102 patients, 47.4%), non-infectious inflammatory diseases (40, 18.6%), malignant diseases (14, 6.5%), other diseases (21, 9.8%) and idiopathic diseases (38, 17.7%). Among the most frequent causal diseases, namely, infectious mononucleosis, meningitis, deep abscess, and infectious endocarditis, the mean patient age at initial consultation was significantly higher for deep abscess and the mean body temperature was significantly lower for infectious mononucleosis. In the population with idiopathic fever, the ratio of patients with infections was lower and that of patients with undetermined causes was higher in the group aged 65 or older, in comparison with the group under 65 years. Seven patients were very old (85 or older). Discussion: Infections were diagnosed in about half of the cases of idiopathic fever. Infectious mononucleosis, infectious endocarditis, deep abscess, and meningitis were particularly frequent, requiring close attention. HIV-related fever of unknown origin, measles, and rubella were relatively frequent as causal diseases. Malignant tumors were wide-ranging, but these lesions now cause fewer cases of idiopathic fever because of the widespread use and advancement of diagnostic imaging systems. The ratio of malignant tumors has decreased from the levels in the past. In 7 patients, 60 or more days were required before determination of diagnosis, because periodic fever was their only symptom and other clues for diagnosis were difficult to obtain. The underlying disease in 2 of these patients was not identified until pathologic autopsy, and both were found to have malignant lymphoma. Diagnosis of idiopathic fever requires knowledge centered on infections and covering a wide range of diseases.
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