Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
Search
Advanced search
OR
Browse
Search
Volume 53, Issue 4
Displaying 1-21 of 21 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
Contents
  • Current surgical treatment for esophageal cancer
    Indication and limitation of 3-field lymph node dissection surgery based on survival analysis
    YOSHIAKI KAJIYAMA, YOSHIMI IWANUMA, NATSUMI TOMITA, TAKAYUKI AMANO, FU ...
    2007 Volume 53 Issue 4 Pages 542-551
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.542
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Three-field lymph node dissection surgery for esophageal cancer was developed in Japan in order to achieve a better survival. However, this surgery requires a high degree of skill, and the morbidity and mortality rate of this surgery is higher than that for other gastrointestinal malignancies. This study investigated the proper indication and actual limitations of this surgery. Survived benefit of lymph node dissection was achieved when the number of lymph node metastase was five or less. However, when the number of lymph node metastase was more than five, mean survival time and Five-year survival rate decreased sharply. 5-year survival rate after 3-field lymph node dissection surgery for stage 2, 3 esophageal cancer was almost 60%, which was superior to that of definitive chemoradiation therapy. The number of lymph node metastase remained as the most powerful prognostic factor after 3-field lymph node dissection surgery. The development of a new effective systemic treatment for advanced esophageal cancer with multiple lymph node metastases is needed in order to improve the control of lymph node metastases.
    View full abstract
    Download PDF (1461K)
  • Progress in endoscopic treatment for esophageal cancer.
    NATSUMI TOMITA, YOSHIAKI KAJIYAMA, TAKAYUKI AMANO, FUYUMI ISAYAMA, KAZ ...
    2007 Volume 53 Issue 4 Pages 552-566
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.552
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Background : Conventional procedures for endoscopic mucosal resection (EMR) and recent procedures for endoscopic submucosal dissection (ESD) are widely used for superficial cancer of esophagus. However, the effect of combining conventional EMR and ESD has not been fully evaluated. Method : We reviewed clinical experience in our hospital regarding EMR for 271 superficial esophageal cancer lesions in 188 patients between April 1998 and June 2007. Conventional EMR (two-channel method, esophageal EMR-tube method and EMR cap-fitted method) and ESD were used. Result : The rate of local recurrence after EMR (conventional EMR+ESD) was 4.4% (12/271). The rate of local recurrence after conventional EMR was 8.0% (12/150). However, the rate after ESD was 0 % (0/121). The rate of complete resection after conventional EMR was 70% (105/150) whereas that rate for ESD was 94.2% (114/121). There are 12 recurrent lesions after conventional EMR, including 10 cases undergoing a second ESD or EMR procedure, one case that underwent surgical treatment and one case treated by chemo radiation therapy. Conclusion : The rate of complete resection by ESD is higher than that by EMR. Moreover, the rate of local recurrence after ESD was lower than that after EMR. Therefore, ESD is considered a more useful method of treating superficial esophageal cancer.
    View full abstract
    Download PDF (3877K)
  • Recent advances in radiotherapy for esophageal cancer
    KUMIKO KARASAWA, KANA ITO, HISAKO HIROWATARI, HIROMI IZAWA, TOMOHISA F ...
    2007 Volume 53 Issue 4 Pages 567-575
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.567
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Although radiotherapy is administered to about half of the cancer patients world wide, radiotherapy is administered to less than one fourth of such patients in Japan. Currently, the number of the patients who receive radiotherapy has been increasing gradually in Japan probably because of the globalization of medical information and aging of the patients. Cancers of the digestive tract are usually good candidates for surgery, but esophageal cancer is also a good candidate for radiotherapy. Most cases are good candidates for chemoradiotherapy using platinum, 5FU and taxans. Chemoradiotherapy using these agents has been reported to improve local control and survival rates. Recent advances in radiotherapy technology, such as intensity modulated radiotherapy (IMRT) and image-guided radiation therapy (IGRT) assure more effective and safer treatment for all cancer patients and further developments in radiotherapy regimens are expected to continue.
    View full abstract
    Download PDF (1826K)
  • Prediction of the effects of chemoradiotherapy based on oncoprotein expression and individualized therapy for squamous cell carcinoma of the esophagus
    TOSHIHARU MATSUMOTO
    2007 Volume 53 Issue 4 Pages 576-580
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.576
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Predictors of the effects of chemoradiotherapy for squamous cell carcinoma (SCC) of the esophagus are reported. Human epidermal growth factor receptor 2 (HER2) expression and low expression of Bax are markers predicting chemoradioresistance, while p21 expression is a marker predicting radiosensitivity. Regarding drugs for molecular targeting therapy for esophageal SCC, Cetuximab (Erbitux), epidermal growth factor receptor (EGFR) antibody, and Transtuzumab (Herceptin), HER2 antibody, have been reported, but the effects of these drugs can not be confirmed. Order made therapy for esophageal SCC should be based on confirmation of the predited effects of chemoradiotherapy and administration of drugs and radiation therapy appropriate for the conditions identified in each patient.
    View full abstract
    Download PDF (1269K)
  • Physical practice and mental stress among Japanese people living in Thailand
    TSUYOSHI MATSUBA, DAICHI SUZUKI, YUTAKA INABA
    2007 Volume 53 Issue 4 Pages 581-587
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.581
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : In Thailand, there were 36,327 (2005) Japanese nationals living in the country mainly for business reasons. This study 1) investigated their environment and level of physical exercise, 2) analyzed the relationship between physical exercise and health-related factors, and 3) obtained useful data for the health promotion among Japanese people living abroad for prolonged periods. Material and Methods : In Dec. 2005, Japanese companies and schools in Thailand were asked to be sampling units, and cluster sampling was performed to obtain data from Japanese subjects over 20 years of age who were living in Thailand for a prolonged period. One hundred eighteen subjects (84 male and 58 female) responded to our questionnaire asking about their personal characteristics and level of physical exercise. Of these 118, 60 consented to blood pressure measurement and 58 consented to visceral fat examination. As a scale of mental stress, GHQ (General Health Questionnaire) 12 was utilized. Results and Discussion : It was demonstrated that accessibility to sports clubs was good among Japanese in Thailand and many of the respondents participated in regular physical exercise. Subjects expected to live in an environment where regular physical exercise could be obtained in excellent sports clubs similar to those in industrialized countries. There were no significant differences in physical factors between the group obtaining regular physical exercise and the group without regular exercise. Although there was no significant difference, diastolic blood pressure was lower among the group with regular physical exercise. About satisfaction with daily life, the group with regular physical exercise showed more positive results. Structure equation model analysis was performed to clarify the relationship among factors, and showed that regular physical exercise influenced health life style more strongly than nutrition and mental stress.
    View full abstract
    Download PDF (942K)
  • Survey of the knowledge, attitude and preventive behavior toward HIV/AIDS among residents living in the border area in Yunnan, China
    ZHANG MINGJI, TSUYOSHI MATSUBA, KOKI KITAGAWA, YATSUKA SAITO, YASUKO S ...
    2007 Volume 53 Issue 4 Pages 588-597
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.588
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : The questionnaire survey on the knowledge, attitude and preventive behavior toward HIV/AIDS was implemented to evaluate health service programs and clarify challenging issues for HIV/AIDS control among residents living in the border area in Yunnan, China. Material and Method : The survey was conducted between 4 Nov. and 12 Nov. 2006 among subjects over 15 years old living in Yunnan, near the border with Myanmar. The survey was conducted by interviewers and self administered questionnaire was also available for some subjects who were literate. Results and Discussion : It was demonstrated that the factors affecting knowledge of HIV/AIDS were mainly residential area and education level. Subjects living in rural area or with an educational level below elementary school graduation answered that they could not distinguish HIV from AIDS, recognized AIDS as an acute mortal disease and did not recognize the risk factors for infection. It was suggested that knowledge strongly influenced attitudes. It was clarified that subjects with limited knowledge about HIV/AIDS were more likely to feel prejudice toward persons living with HIV/AIDS. Differences in these factors affected the level of knowledge, and subsequently influenced appropriate attitudes and preventive behaviors. Improvement of those factors seemed to be a significant challenge. First, living standards and social standards including educational infrastructures should be improved in order to provide these subjects with a disease control program and raise their awareness of HIV/AIDS. It is expected that health education techniques such as roll playing among illiterate residents and other methods concerning the culture of minority residents urgently need to be implemented.
    View full abstract
    Download PDF (1155K)
  • Advanced elderly patients with febrile episode on admission
    YUKIKO FUKUDA, EIICHIRO SUGIHARA, NAOYA NAKAJIMA, MIYOJI AIBA, HIROSHI ...
    2007 Volume 53 Issue 4 Pages 598-604
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.598
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : Febrile episode is a common symptom presenting in various diseases. In elderly patients, it is difficult to determine the cause of fever at the initial stage, because these patients often showed the atypical clinical features. Therefore, we analyzed advanced elderly patients with febrile episodes to clarify the cause of fever retrospectively. Moreover, it was investigated whether there were differences in clinical conditions between patients with low-grade fever (<38°C) and those with high-grade fever (≥38°C). Materials and Methods : The subjects were 107 advanced elderly patients aged 75 years or older who needed hospitalization due to fever after an initial visit to Geriatric Medicine, Juntendo Tokyo Koto Geriatric Medical Center, between June 2002 and September 2006. The subjects were divided into two groups; low-grade fever group (<38°C) and high-grade fever group (≥38°C). We examined the etiologies of febrile episode, white blood cells counts, ratio of neutrophils and CRP as inflammatory findings, and concentrations of total protein and albumin in serum. Results : The etiologies of the febrile episodes were mainly due to respiratory infection and urinary tract infection. These diseases showed high values of inflammatory findings, however, there were no significant differences in inflammatory findings such as, white blood cell (WBC count, neutrophil ratio, and CRP value between two groups. Patients with pneumonia showed the highest values of inflammatory findings. Conclusions : It is important to be aware that respiratory and urinary tract infections often cause febrile episodes in advanced elderly people and investigate these possibilities at the initial stage. It might be useful to measure the neutrophil ratio and CRP values to detect infectious diseases. However, the severity of the initial fever does not relate to clinical situations in the elderly patients with febrile episodes. On the contrary, it is suggested that death of patients in the low-grade fever group occurs more commonly than that in the high-grade fever group.
    View full abstract
    Download PDF (923K)
  • Research on administrators' satisfaction and concern about supportive environments in the process of health policy making within municipalities
    HIROKO SUKETOMO, YUTAKA INABA, NORIO SHIMANOUCHI
    2007 Volume 53 Issue 4 Pages 605-614
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.605
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : To ascertain the relationship between administrators' attributes, attitudes and lifestyles, and supportive environmental indicators of health policy and satisfaction with the process of policy-making at the local levels. Materials and Methods : Researchers conducted a survey by mail, targeting health policy administrators in 509 municipalities in the Kanto district, Japan. The study respondents were asked about the presence of specific factors, current analytical factors and decision-making factors related to issues and subjects, how policy is formed, indicators in the policy, their satisfaction with the process of policy-making, and their beliefs and conditions. Among these populations, 274 persons (60.2% of responders) responded; 143 respondents answered questions about satisfaction and 149 answered questions about the supportive environmental indicators. Relations were analyzed using x2 test. Logistic regression analysis was implemented to consider the odds ratio and 95% confidence interval. Results : Logistic regression analysis showed that supportive environments were characterized by obtaining other sections' policies related to health, coordination inside the agency, and being able to talk extensively with colleagues. Satisfaction about the process of making health policy was related to the administrators' subjective health, exchange among other municipalities, and ability to attend to business spontaneously. Opinions about health policy and epidemiology were connected with satisfaction and supportive environmental indicators, and in contrast, the absence of neighboring communities as one of the settings for health and not providing meals as a health promotion policy, with supportive environmental indicators and satisfaction affected their beliefs and conditions. Involving the staff in other sections as participants in policy making was an important factor within the indicators. Conclusions : This study suggested that making contact with other sections inside an agency and with other municipalities outside, formally and informally, not only promotes administrators' satisfaction but also establishes supportive environments providing city information. Paradoxically, respondents expressed very specific ideas about what should count as health promotion. For instance, they are interested in supportive environments for health, not in providing meals as potential health promotion, nor neighboring communities as one of the settings for health, although they are providers of health services. Therefore, researchers should investigate the actual situation focusing on these inconsistencies.
    View full abstract
    Download PDF (1442K)
  • The relationship between vertical kinetic visual acuity and visual evoked potential
    HIROSHI YOSHIGI, YOSHIMITSU KOHMURA, MINORU TANAKA, ATSUSHI MIZOTA
    2007 Volume 53 Issue 4 Pages 615-621
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.615
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : We examined the correlation between vertical kinetic visual acuity (VKVA) and pattern reversal visual evoked potential (VEP). Subjects : Sixteen normal male volunteers with corrected visual acuity of 1.0 or better (age : 19-25 year-old). Methods : Static visual acuity (SVA), VKVA and pattern reversal VEPs were recorded in all subjects and the correlations between VEP and logMAR visual acuity of SVA and VKVA were analyzed. Results : There was no correlation between VEP and SVA. In VKVA, but there was an inverse correlation to the peak latency of N75 components of VEP, indicating that the peak latency of N75 decreased with the increase of VKVA. Conclusions : We found a correlation between the peak latency of N75 components of VEP and VKVA. These findings suggest that the initial response of the primary visual cortex is related to VKVA.
    View full abstract
    Download PDF (860K)
  • Prediction of higher brain functional outcomes for patients with cerebrovascular disease before rehabilitation
    TAKAO KIMIZUKA, FUMIHIKO TAMAMOTO
    2007 Volume 53 Issue 4 Pages 622-630
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.622
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : This paper investigated the prediction of higher brain functional (HBF) outcomes for patients with cerebrovascular disease (CVD) based on cerebral blood flow (CBF) scintigraphy findings before rehabilitation. Patients : The study included 204 patients with CVD but no prior history of CVD, surgery, or practical rehabilitation in any other facilities. Methods : The effect of rehabilitation was evaluated by cognitive-Functional Independence Measure (FIM) score, which is also known as an HBF score, before and after rehabilitation. Cerebral blood flow (CBF) scintigraphy was performed using 99mTc-ECD (600MBq) before rehabilitation. Regional cerebral blood flow (rCBF) value was achieved utililizing the Patlak plot method. The correlation between rCBF and HBF score was investigated utilizing Spearman's rank correlation coefficient. Results : The rCBF value from the affected side before rehabilitation tended to correlate positively with HBF score. The rCBF value from the affected side before rehabilitation tended to correlate with HBF score only after rehabilitation. Conclusion : The rCBF value measurement before rehabilitation using 99mTc-ECD may be useful to predict HBF outcomes for patients with CVD before rehabilitation.
    View full abstract
    Download PDF (1346K)
  • Potential role of dendritic cells in murine IgA nephropathy through regulation of B cell growth and differentiation
    MASAO KIHARA, YUSUKE SUZUKI, MASASHI AIZAWA, HITOSHI SUZUKI, SATOSHI H ...
    2007 Volume 53 Issue 4 Pages 631-638
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.631
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : Although IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis, the pathogenesis remains unclear. Our recent studies demonstrated that the “grouped ddY mouse” is a useful model to approach the pathogenesis of IgAN because it shows disease progression with strong Th1 polarization. Moreover, serum levels of IgA/IgG2a immune complex were significantly correlated with the severity of glomerular lesions. Dysregulation of the mucosal immune response of IgAN patients has been discussed in this pathogenic process and mucosal dendritic cells (DCs) are key regulators of both T and B cell functions. Recent studies demonstrated that DCs directly regulate mature B cell responses at various stages of differentiation. Accordingly, the present study investigated the role of DCs through humoral immunity in ddY mice with the early stage of IgAN. Materials and Methods : DCs from the spleens of diseased and quiescent ddY mice or B cells from normal BALB /c mice were prepared using a magnetic cell sorting system. Purified B cells were cocultured with the DCs isolated from diseased and quiescent ddY mice. IgA production in the supernatants was measured by ELISA, and we analyzed mRNA expression of APRIL and IL-6. Results : DCs from diseased ddY mice strongly induced B cells to produce higher levels of IgA than those from quiescent mice. Moreover, mRNA expressions of APRIL and IL-6 in DCs from diseased ddY mice were higher than those from quiescent ddY mice. Conclusion : The present data suggest that DCs may play key roles in the pathogenesis of murine IgAN through regulation of humoral immunity.
    View full abstract
    Download PDF (1211K)
  • Effects of erythropoietin on the peritoneum in chlorhexidine gluconate-induced peritoneal sclerosis rat models
    JIRO INUMA, CHIEKO HAMADA, TETSUTARO SHIMAOKA, YOSHIMI SEKIGUCHI, YOKO ...
    2007 Volume 53 Issue 4 Pages 639-646
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.639
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Objective : Severe thickening of peritoneum with vasculopathy is a characteristic finding in longterm peritoneal dialysis patients. The mechanism underlying peritoneal fibrosis and methods of prevention remain unclear. Erythropoietin (Epo) used for renal anemia may attenuate interstitial fibrosis via the inhibition of transforming growth factor-β1 (TGF-β1) in a mouse model of obstructed kidney. In the present study, we examined the effects of Epo in an experimental animal model of peritoneal fibrosis induced by chlorhexidine gluconate (CG) injection. Materials and Methods : Sprague-Dawley rats at 8 weeks of age were used. The rats were intraperitoneally administered CG and Epo (CG+Epo group), CG alone (CG group), Epo alone (Epo group) for 28 days. A control group was also established. Expressions of hypoxia-inducible factor-1α (HIF-1α), erythropoietin receptor (Epo R), and pimonidazole were evaluated by immunohistochemistry. HIF-1α, TGF-β1 and connective tissue growth factor (CTGF) were also examined by real-time PCR. Results : Peritoneal fibrosis developed in the CG group and it was suppressed by Epo administration. Hypoxic cells, expressing Epo R, HIF-1α or pimonidazole positive cells in the submesothelial compact zone, were observed in the CG and CG + Epo group. In the CG group, these cells were more numerous than those in the CG +Epo group. Hematocrit in the CG +Epo group was significantly higher than that in the CG group. The expressions of HIF-1α, TGF-β1 and CTGF mRNA markedly increased in the CG group, although those were reduced in the CG + Epo group. Conclusion : In the present study, we demonstrated that repeated CG exposures resulted in peritoneal hypoxia. Epo may play an important role in ameliorating peritoneal fibrosis via improvement of hypoxia and decreasing CTGF production by inhibition of TGF-β1 expression in CG-induced peritoneal sclerosis rat models.
    View full abstract
    Download PDF (4208K)
  • Treatment with Retrieval Type Vena Cava Filter for Deep Vein Thrombosis in Superior Vena Cava : A Case Report
    TETSUO ICHINOSE, SATORU SUWA, MASAKI KAWAMURA, TOSHIHIRO KANEMURA, TAD ...
    2007 Volume 53 Issue 4 Pages 647-650
    Published: December 22, 2007
    Released on J-STAGE: November 12, 2014
    DOIhttps://doi.org/10.14789/pjmj.53.647
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    We describe 62 year-old man with upper extremity deep vein thrombosis that was treated with thrombolysis and anticoagulant therapy after placement of a retrieval type vena cava filter (Günther TulipTM Vena Cava Filter) into the proximal superior vena cava (SVC). Filter replacement in the SVC was performed safely without any complications such as filter migration or vascular injury. After thrombolysis, some floating thrombi were observed in the SVC. Therefore, the filter was not retrieved. Despite anticoagulant therapy with warfarin at our outpatient clinic, thrombus in the SVC enlarged. However, after the second thrombolysis session, the thrombus disappeared. Permanent filter placement may be benefical in high-risk patients with pulmonary thromboembolism.
    View full abstract
    Download PDF (692K)
  • Retraction: Ryota Tanaka: The therapeutic potential for cerebral infarction using neural stem cells
    2007 Volume 53 Issue 4 Pages 53_E1
    Published: December 22, 2007
    Released on J-STAGE: April 16, 2015
    DOIhttps://doi.org/10.14789/pjmj.53.53_E1
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    We hereby notify, in relation to "Ryota Tanaka: The therapeutic potential for cerebral infarction using neural stem cells" published in Juntendo Medical Journal, Vol.52, No.1 (2006), pp.2-10, as follows: 1. A foreign researcher has claimed that the author published the researcher's paper containing unpublished diagrams and figures as the author's own article without obtaining prior con-sent from him. The author accepted the claim and agreed to withdraw the article. 2. Therefore , we have decided to suspend the publication of the article , and deleted files con-taining it in the retrieval system on the Internet. 3. We would like to ask readers to delete the article mentioned above from the printed versions of Juntendo Medical Journal.
    View full abstract
    Download PDF (71K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top