Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 56, Issue 2
Displaying 1-12 of 12 articles from this issue
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Contents
  • Japan-Indonesia Collaborative Study of Imidapril on Antiproteinuric Effect in Hypertensive Patients with Chronic Kidney Disease (CKD)
    TOSHINAO TSUGE, WIGUNO PRODJOSUDJADI, MOHAMMAD YOGIANTORO, ATSUSHI KUR ...
    2010 Volume 56 Issue 2 Pages 100-106
    Published: April 30, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.100
    JOURNAL FREE ACCESS
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    Background: Chronic kidney disease (CKD) is a comprehensive disease concept that includes chronic glomerulonephritis such as IgA nephropathy or lupus nephritis, diabetic nephropathy and hypertensive nephrosclerosis. CKD is a risk factor for end stage kidney disease (ESKD) and cardiovascular diseases (CVD). It is considered that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) induce a marked renoprotective effect in patients with CKD. The purpose of the present Japan-Indonesia collaborative study was to evaluate the antiproteinuric effect of imidapril, one of the ACEIs, in hypertensive patients with CKD. Methods: Twenty three hypertensive CKD patients were treated with imidapril and a calcium channel blocker (CCB). Imidapril was added for patients who had been treated with a CCB such as diltiazem at the start of this study. When blood pressure (BP) did not reach the target level (<130/85 mmHg), imidapril dosage was increased to 10 mg/day and administered for 12 months. Alternatively, patients were treated with 5-10 mg/day of imidapril. Results: In the imidapril + CCB combination therapy, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly reduced, both at 6 months and at the end of the clinical study. Only DBP reached values below the target level. Urinary albumin excretion (UAE) levels were markedly decreased at 6 and 12 months when compared with the baseline values (0.45 ± 0.54g/g·Cr indicating typical overt proteinuria) and these decreases at both time points were significant. The UAE levels at both 6 and 12 months complied with the diagnostic criteria for microalbuminuria (< 0.299 g/g·Cr). Conclusion: In this collaborative study, a combination of imidapril and a CCB, such as diltiazem, significantly reduced BP, and reduced UAE, suggesting strict BP control may induce an efficient decrease in UAE. It appears that imidapril-based therapy has renoprotective effects in hypertensive patients with CKD.
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  • Quantitative Trait Loci analysis for Type 2 Diabetic Nephropathy in KK-Ay/Ta Mice
    TATSUYA AOKI, SHIGERU KANEKO, MITSUO TANIMOTO, SHINJI HAGIWARA, MAKI M ...
    2010 Volume 56 Issue 2 Pages 107-115
    Published: April 30, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.107
    JOURNAL FREE ACCESS
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    Objective : Pathogenesis and development of human diabetic nephropathy involve in genetic factors. Since human diabetic nephropathy is a heterogeneous disorder, it is difficult to identify the responsible gene loci. Previously, we reported that the KK-Ay/Ta mouse is a suitable model for type 2 diabetic nephropathy. In the present study, we investigated the candidate gene loci for diabetic nephropathy using quantitative trait locus (QTL) analysis of KK-Ay/Ta × BALB/cA F2 intercross mice. Materials : KK-Ay/Ta and BALB/cA mice. Methods : Two hundred seventy (KK-Ay/Ta × BALB/cA) F2 intercross mice were used in this study. Urinary albumin/creatinine ratio (ACR), HbA1 c and fasting body weight were measured at 8. 12. 16 and 20 weeks of age. The genotype was investigated by 85 microsatellite markers and QTL analysis was performed. Results : ACR in mice at 20 weeks of age showed a suggestive linkage with the interval on chromosome 9 with LOD of 3.8. The gene loci that contributed to HbA1 c indicated a significant linkage to chromosome 7 (LOD 5.8, 8.9) and fasting body weight indicated a significant linkage to chromosome 1 (LOD 5.5, 5.2) in mice at 8 and 20 weeks of age. Conclusions : On QTL analysis of KK-Ay/Ta mice, several new loci contributing to diabetic nephropathy and related phenotypes were identified. It appears that type 2 diabetes and nephropathy of KK-Ay/Ta mice involve different genetic factors, but the two may act complementarily
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  • Statistical Analysis of a Hospital-Based Study on Elderly Cerebral Infarction Patients at Juntendo University Hospital
    with Special Emphasis on Number of Days Between Onset and Hospitalization
    EISUKE MAJIMA, TAKAO URABE, NOBUTAKA HATTORI, YUTAKA INABA
    2010 Volume 56 Issue 2 Pages 116-122
    Published: April 30, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.116
    JOURNAL FREE ACCESS
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    Objective : This study investigated the prevalence of and risk factors associated with cerebral infarction subtypes, and their association with the interval until hospitalization at Juntendo University Hospital. Patients and Methods : We examined hospitalization records of 362 cerebral infarction patients aged 65 years or older who had been treated between January 1, 2003 and December 31, 2005, and analyzed the association of thrombotic (lacunar and atherothrombotic cerebral infarction) and embolic (cardioembolic infarction) cerebral infarction with the risk factors for arteriosclerosis that comprise metabolic syndrome. We next examined the association between the number of days between onset and hospitalization due to thrombotic and embolic cerebral infarction by classifying cases into 2 periods : less than 48 hours or 2-7 days. We also examined the association between the number of days from onset to hospitalization with age and gender. Results : While a history of hypertension was significantly associated with thrombotic cerebral infarction when comparing cerebral infarction subtypes (embolic and thrombotic) and risk factors for arteriosclerosis, other risk factors for arteriosclerosis were not associated with cerebral infarction subtype. There was no association between cerebral infarction subtype and number of days between onset and hospitalization stratified by risk factors for arteriosclerosis. A significant difference was found for hospitalization within less than 48 hours between thrombotic (177/238, 74.4 %) and embolic (52/55, 94.5 %) subtypes; patients with the latter subtype were hospitalized earlier. A significant difference was also seen between both genders and all ages when the number of days from onset to hospitalization was compared. Discussion : Potential reasons for the low association between cerebral infarction with risk factors that comprise metabolic syndrome versus the significant association with hypertension include : a large number of cases with cerebral infarction involving a penetrating artery, considerable differences in epidemiological research design (this was a cross-sectional, rather than a longitudinal study), and the use of a study population from a university hospital (severe cases are more common in this population compared to the incidence at a general hospitals). We found that embolic cerebral infarction patients underwent earlier hospitalization compared to thrombotic cerebral infarction patients, likely because onset of cerebral embolism can be clearly diagnosed at an early stage due to the rapid development of symptoms.
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  • Establishment of an Animal Experimental Model of Leukocytapheresis in Order to Elucidate the Mechanism Underlying the Curative-Effect on Rheumatoid Arthritis
    KEISUKE ODA, KEN YAMAJI, KAORU SUGIMOTO, YOSHINARI TAKASAKI
    2010 Volume 56 Issue 2 Pages 123-129
    Published: April 30, 2010
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.56.123
    JOURNAL FREE ACCESS
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    Objective : An arthritis rat model was developed for elucidating the therapeutic effects of leukocytapheresis (LCAP), which is known to be effective for human rheumatoid arthritis. We established an animal experimental model of leukocytapheresis in order to elucidate the mechanism underlying the curative-effect of this treatment on rheumatoid arthritis. Materials & Methods : LEW arthritis rat models were treated with a micro LCAP column. Joint swelling and destruction were compared with those in rats without LCAP. Measurement and Results : Significantly less joint swelling and destruction, and some histopathological findings were observed in the LCAP group. Conclusions : This study indicated that this rat model was useful for elucidating the mechanism underlying the therapeutic effect of LCAP for arthritis.
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