Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 56, Issue 1
Displaying 1-18 of 18 articles from this issue
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Contents
  • Prospects of Electrical Stimulation Therapy in Rehabilitation
    KOJI WATANABE, MASANORI NAGAOKA
    2010 Volume 56 Issue 1 Pages 29-36
    Published: February 28, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.29
    JOURNAL FREE ACCESS
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    Although there is hardly any evidence supporting the effect of electrical stimulation therapy in rehabilitation, such stimulations are applied to relieve pain and strengthen muscle power. In this review, we discuss the reasons that the effectiveness of this method has not been proven, and consider the prospects of electrical stimulation therapy along with the introduction of two new methods. We outlined various stimulus conditions related to different aims in electrical stimulation therapy. In most conventional methods, nerves and muscles are targeted, but effects on increasing glucose transporter protein, vascularization, and local blood flow have been reported in recent years. These conventional applications of electrical stimulation lack the physiological mechanisms underlying volitional contraction. To compensate for this disadvantage, hybrid exercise and integrated volitional control electrical stimulator are proposed as new methods. These techniques simulate physiological conditions by combining electrical stimulation with simultaneous voluntary contraction. We can expect further development of new applications of electrical stimulation in combination with other therapeutic exercises.
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  • Reactive Oxygen Species, Nitric Oxide and the Kidney
    MOCHAMMAD THAHA, EMILIA S TANUSEPUTRA, YASUHIKO TOMINO
    2010 Volume 56 Issue 1 Pages 37-44
    Published: February 28, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.37
    JOURNAL FREE ACCESS
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    Nitric oxide (NO) is a potent, endogenous vasodilator that regulates various functions including systemic blood pressure and renal function, among other functions. The bioactivity of NO is reduced by superoxide, a major reactive oxygen species. Overproduction of superoxide and other related reactive oxygen species resulting in oxidative stress reduces the biological effects of NO. Although both of these highly reactive species play distinct roles in other pathways, their interaction is emerging as a major regulatory factor in normal and pathological renal function. Endothelial nitric oxide synthase (eNOS) is one of three isoforms of NOS that exhibits homology of sequence and function and plays a crucial role in regulating a wide spectrum of the cardiovascular (CV) system. Biochemically, endothelial NO production is regulated at three different levels, namely eNOS gene expression, eNOS enzymatic activity and degradation of NO. Dysfunction of any of these mechanisms can cause endothelial dysfunction. In this review, recent studies on NO in the kidney are highlighted, focusing on the interactions of these mechanisms under normal and pathological conditions as well as examining Glu298Asp polymorphism in end stage kidney disease (ESKD) patients in the dialysis unit of the Internal Medicine Department, Medical Faculty Airlangga University, Surabaya, Indonesia.
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  • Changes in The physician's Perception of Evaluators During Postgraduate Medical Education
    TADASHI KAGAMI, KAZUO KENPE, RIE SAKAI, TAKASHI DAMBARA
    2010 Volume 56 Issue 1 Pages 45-49
    Published: February 28, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.45
    JOURNAL FREE ACCESS
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    Objective : Medical school faculty members are evaluated by students during medical school education;however, evaluation during postgraduate education is rarely conducted except in graduate schools. In this study, we investigated the attitudes of physicians toward various evaluators during their postgraduate education. Method : A questionnaire survey was conducted among 1,186 graduates of Juntendo University Faculty of Medicine. The questionnaire was sent by mail to physicians who graduated between 1992 (17 years post-graduation) and 2006 (3 years post-graduation). Evaluators were categorized as supervisors, colleagues, paramedical staff, patients, self, and academic/medical associations, and responses were collected on which evaluator most effectively contributed to improving education during their postgraduate education. Result : The response rate was 40.6 %. Our study showed that graduates 3-7years post-graduation considered their supervisors and academic/medical associations to be the most effective evaluators, graduates 8-12 years post-graduation considered patients and colleagues to be the most effective, and graduates 13-17 years post-graduation considered colleagues and paramedical staff to be the most effective. Across the entire range of postgraduate years, very few physicians considered evaluations from students to be effective. Conclusion : Our study suggests that with increase in the number of postgraduate years, evaluators that are considered to have effectively contributed to a physician's professional growth and self-improvement shift from direct educational supervisors to colleagues with whom they collaborated in clinical settings.
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  • Proinflammatory Response in Human Keratinocytes Stimulated with Ligands for TLR2, TLR1, and TLR6
    ANH TUAN VU, TOSHIRO TAKAI, TUAN ANH LE, HIROKAZU KINOSHITA, SEIJI KAM ...
    2010 Volume 56 Issue 1 Pages 50-55
    Published: February 28, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.50
    JOURNAL FREE ACCESS
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    Objectives : Staphylococcus aureus has been reported to be heavily colonized on the skin of atopic dermatitis patients.S.aureus components could contribute to the initiation and exacerbation of atopic dermatitis.Recognition of pathogen-associated molecular patterns via Toll-like receptors (TLRs) triggers innate immunity, linking to the establishment of adaptive immune responses.S.aureus produces TLR2 ligands, such as peptideglycan, lipoteicoic acid, and lipoproteins.Here, we analyzed proinflammatory responses in keratinocytes stimulated with a synthetic diacyl lipopeptide to elucidate its possible role as a Th2 adjuvant in the pathogenesis of atopic dermatitis. Methods : Induction of proinflammatory cytokines and chemokines in primary human keratinocytes stimulated with three TLR2 ligands, peptideglycan, a synthetic triacyl lipopeptide, and a synthetic diacyl lipopeptide were analyzed by ELISA and quantitative PCR. Results : We demonstrated that the diacyl lipopeptide, a ligand for the complex of TLR2 and TLR6, induced the release of CXCL8/IL-8 more effectively than the triacyl lipopeptide, a ligand for the complex of TLR2 and TLR1, and peptideglycan.The diacyl lipopeptide induced gene expression of proinflammatory cytokines and chemokines including CXCL8/IL-8, GM-CSF, and CCL5/RANTES, more effectively than the triacyl lipopeptide. Conclusions : The results suggest an important role of the TLR2-TLR6 complex in the TLR2 pathway in keratinocytes and a possible contribution of S.aureus -derived diacyl lipoproteins to the pathogenesis of atopic dermatitis.
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  • A Study on the High Virulence of Community-associated MRSA (CA-MRSA) : The Effect of Oxacillin High-resistance and Presence of fudoh Region
    TAKASHI CHINO, TOMOMI HISHINUMA, MIKI MATSUO, MOE CHOU, TERUYO ITO, YU ...
    2010 Volume 56 Issue 1 Pages 56-67
    Published: February 28, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.56
    JOURNAL FREE ACCESS
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    Emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a worldwide trend in the last decade. High virulence of CA-MRSA is considered associated with its ability to produce the toxin called Panton-Valentine leukocidin (PVL) that destroys human leukocytes. CA-MRSA is distinct from extant MRSA, designated as healthcare-associated MRSA (HA- MRSA), in its low resistance level to beta-lactam antibiotics and limited resistance profile to various non-beta-lactam antibiotics. It also carries on the chromosome a different repertoire of staphylococcal cassette chromosome mec (SCCmec), the mobile genetic element that converts methicillin-susceptible S. aureus (MSSA) to MRSA. Recently, CA-MRSA has started to invade hospitals and has started to acquire high beta-lactam resistance following exposure to various potent beta-lactam antibiotics. This has prompted our evaluation of the effect of acquiring high beta-lactam resistance on the expression of various virulence genes by the representative CA-MRSA strain USA300 FPR3757 using microarray transcription analysis. We also tested the effect on the transcription of the virulence gene of the fudoh region that is characteristically found on the SCCmec carried by HA-MRSA chromosome. Our findings showed an unexpected increase in toxin gene transcription in the highly oxacillin-resistant mutants compared with that in its parent USA300 strain. The introduction of fudoh leads to down regulation of many virulence genes in agreement with previous observations of reduced virulence in an animal infection model. The findings of our study suggest that therapeutic use of beta-lactam antibiotics against CA-MRSA might lead to the emergence of more virulent derivative strains of CA-MRSA in the hospital.
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  • Four Cases of Tetanus : Its Diagnosis and Management of Complications
    KIMIKO OBI, MAKI KAGOHASHI, TAKU HATANO, KENJI FUJISHIMA, TOHRU KITADA ...
    2010 Volume 56 Issue 1 Pages 68-72
    Published: February 28, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.68
    JOURNAL FREE ACCESS
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    We report four patients with tetanus who were treated successfully. The initial symptoms of our patients varied. Dysphagia preceded trismus in three of the four patients, and two patients were initially misdiagnosed as having a new stroke. Two severely affected patients showed respiratory distress and autonomic dysfunction, and required mechanical ventilation. One elderly patient exhibited a transient myoclonic state. Although rare in developed countries, tetanus should be considered when encountering a patient with dysphagia and dysarthria, and later showing difficulty in opening the mouth. Intensive care is necessary for patients with generalized tetanus. Elderly patients should particularly be treated carefully because the prognosis remains poor.
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