Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 57, Issue 4
Displaying 1-20 of 20 articles from this issue
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Contents
  • Regeneration therapy for heart disease
    SATOSHI MATSUSHITA
    2011 Volume 57 Issue 4 Pages 324-328
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.324
    JOURNAL FREE ACCESS
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    As the number of patients with cardiovascular disease increases in Japan, regenerative medicine is offering a promising novel option for cardiovascular disease as a supplement to conventional therapy. Regenerative medicine, including cell therapy, cytokine replacement therapy or gene therapy, has not yet been confirmed as a standard therapy for heart disease, although many clinical trials reported its effectiveness. Our laboratory is one of the most advanced labs in the regenerative medical field, especially for cardiac stem cells. In this paper, recent developments in regeneration therapy based on our current research will be reported.
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  • Establishment of self-tolerance in the thymus
    AKIHITO NAKAJIMA
    2011 Volume 57 Issue 4 Pages 329-335
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.329
    JOURNAL FREE ACCESS
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    T cells are developed in the thymus to generate a functional immune system. In addition, T cells are required to obtain self-tolerance by positive and negative selection to prevent an autoimmune response. The mechanism by which T cells obtain self-tolerance in the thymus is not fully understood. AIRE (autoimmune regulator) was identified as a cause of APECED (autoimmune polyendocrinopathy -candidiasis-ectodermal dystrophy). AIRE is specifically expressed in the medullary thymic epithelial cells and plays an important role in deleting autoreactive T cells by presenting many peripheral self-antigens promiscuously. However, the precise mechanism of AIRE remains largely unknown. In this study, NOD1 (Nucleotide-binding oligomerization domain-containing protein 1) was identified as a novel binding partner for AIRE. AIRE interacts with NOD1, which is characterized as a bacterial sensor in the cytoplasm. NOD1 promotes the induction of AIRE-dependent self-antigens in vitro. Furthermore, the expression of AIRE-dependent antigens is reduced in Nod1-/- mice compared to that in wild type mice, indicating that NOD1 promotes AIRE function. This finding suggests that bacteria might be involved in AIRE function and clonal deletion of autoreactive T cells. These findings also provide new insight into the contribution of bacteria to negative selection.
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  • The analysis of PGRMC1 expression and function in endometrial cancer cells
    HIROSHI KANEDA
    2011 Volume 57 Issue 4 Pages 336-344
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.336
    JOURNAL FREE ACCESS
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    PGRMC1 (progesterone receptor membrane component 1), one of the progesterone receptor purified from porcine liver membranes in 1996, is widely seen in human kidney, liver, endometrium and ovary relatively strong expressed. Its functions which are metabolism and synthesis of steroid hormones and electrolyte have been elucidated in a variety cells including anti-apoptosis action in spontaneously immortalized granulosa cells. PGRMC1 also has been seen in breast cancer cells, thyroid, colon, lung, ovarian cancer, especially in breast cancer the expression of PGRMC1 was reported to have an association with prognosis, which indicates PGRMC1 can have a role in tumorigenesis. PGRMC1 are also highly expressed in Ishikawa cell, human endometrial cancer cells, in which PI3K/AKT and MAPK pathway are over-expressed. PGRMC1 knock-down showed to reduce the expression of PDK1 and phosphorylated-AKT on the PI3K/AKT signal pathway, but no effect on MAPK signaling. Furthermore PGRMC1 knock-down showed to induce apoptosis and, under hypoxic stress showed antitumor effects by suppressing the activity in Ishikawa cell. Our works indicates that in endometrial cancer cell, PGRMC1 can have a crosstalk with PI3K/AKT signal pathway through PDK1 and AKT to maintain the cell for survival. The results suggest that the regulation of PGRMC1 is critical for Ishikawa cells, therefore PGRMC1 can be a one potential molecular target for the therapeutic treatment of endometrial cancer.
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  • Congenital diaphragmatic hernia : pathophysiology and its management
    TADAHARU OKAZAKI
    2011 Volume 57 Issue 4 Pages 345-350
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.345
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    Despite recent advances in neonatology and pediatric surgery, the mortality rate for infants with congenital diaphragmatic hernia (CDH) still remains high. Persistent pulmonary hypertension (PPH) is intimately associated with the pathophysiology of cardiopulmonary distress in CDH. To predict severity of PPH, we have introduced echocardiography to evaluate PPH, protocolized management, and new surgical techniques. Herein, we describe our management and show significance of pulmonary artery size and blood flow as predictor of outcome in CDH.
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  • Immunological analysis of pediatric inflammatory bowel disease
    YOSHIKAZU OHTSUKA
    2011 Volume 57 Issue 4 Pages 351-359
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.351
    JOURNAL FREE ACCESS
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    Inflammatory bowel disease (IBD) in children is increasing in Japan. Although several genetic and environmental factors are known to be involved in the pathogenesis of IBD, the etiology of IBD is not fully understood. To investigate the pathogenesis of pediatric IBD, microarray analysis was performed using biopsy samples taken from Crohn's disease (CD) in the active phase and in remission, ulcerative colitis (UC) in the active phase and in remission, food allergy patients and controls. Microarray analysis demonstrated enhanced expression of IFN-γ, IL-6, IL-8, STAT4, GATA3, CCR7, and CXCL13 in both CD and UC patients. Furthermore, enhanced expression of CXCL10, CXCL9, CXCL11 in CD patients and MMP7, MMP3, MMP10 in UC patients were confirmed. Since CXCL10, CXCL9, CXCL11, and CXCL13 are lymphocyte chemotactic factors and involved in the formation of lymphoid follicles, enhanced expression of these molecules may be involved in the pathogenesis of more severe inflammation observed in pediatric IBD patients. Furthermore, we have been investigated the anti-inflammatory effects of probiotics and n-3 longchain polyunsaturated fatty acids; such as DHA and EPA, and found that these molecules can reduce the expression of inflammatory genes related to pediatric IBD patients. Our study suggests that nutritional support with probiotics and DHA will be beneficial in induction and maintenance therapy for pediatric IBD patients.
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  • Emergency medical care in Fukuoka City
    RYOICHI AKIMOTO
    2011 Volume 57 Issue 4 Pages 360-364
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.360
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    Fukuoka City's emergency medical care system has been maintained in relatively good condition. Fukuoka City Emergency Hospitals Association (FEHA) was established in 1965 by 23 private surgical hospitals and these institutions have played a central role in maintaining and developing Fukuoka City's emergency medical care system. Since its development, FEHA has been arranging emergency medical care in the city, and has made an effort to educate and train medical personnel. In recent years, however, the Japanese government has enacted policies to control medical expenses and these policies have created many problems. For example, private emergency institutes without funding are now facing difficult economic situations. Keeping the public safe and maintaining appropriate emergency medical care is important. For this reason, FEHA will continue making an effort to communicate with its members, clarifying their specific medical function. Reactivating small private emergency institutes is the key to maintaining an intact emergency medical care system in Fukuoka city.
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  • Susceptibilities of multidrug-resistant Neisseria gonorrhoeae for alternative antimicrobials including nitrofurantoin and fosfomycin
    NAMIKO TAKAHASHI, MASAYUKI SAWAMURA, KEN KIKUCHI, KEIICHI HIRAMATSU
    2011 Volume 57 Issue 4 Pages 365-369
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.365
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    Alternative therapeutics for multidrug-resistant Neisseria gonorrhoeae (MDRNG) was explored. To search for an alternative agent for MDRNG infections, we determined the minimal inhibitory concentration (MIC) of 14 antimicrobials including nitrofurantoin (NIT) and fosfomycin (FOF) against 180 N.gonorrhoeae strains. A total of 180 non-duplicate N.gonorrhoeae strains were collected at Sakura Clinic, Tokyo between 2006 and 2007. The MIC of each drug was determined by Etest. MDRNG was defined as a strain with resistance to 3 different classes of antimicrobials, ciprofloxacin (CIP), tetracycline (TET), and benzylpenicillin (PEN) or cefixime. There were only 44 (24.4%), 46 (25.6%), 4 (2.2%), and 16 (8.9%) strains sensitive to CIP, gatifloxacin, PEN, and TET, respectively. None of the strains were resistant to ceftriaxone or spectinomycin. Eighty-three (46.1%) strains were categorized as MDRNG. Among 5 drugs (NIT, FOF, chloramphenicol, sulfamethoxazole/trimethoprim, and azithromycin) that are not routinely used to treat gonorrhea, there were no isolates including the 83 MDRNG, that were resistant to NIT (MIC, ?128μg/ml) and FOF (MIC, ?256μg/ml) according to tentative breakpoints for Enterobacteriae. Though the susceptibility criteria for NIT and FOF against N.gonorrhoeae have not been established, both drugs might provide effective alternative treatments for MDRNG infections.
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  • Mechanism of linezolid resistance in methicillin-resistant Staphylococcus aureus isolated from a patient with mediastinitis
    YUKA ONO, KEN KIKUCHI, JIN JINGXUN, SATOSHI HORI, KEIICHI HIRAMATSU
    2011 Volume 57 Issue 4 Pages 370-376
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.370
    JOURNAL FREE ACCESS
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    We studied the mechanism of emergent linezolid (LZD) -resistance in methicillin-resistant Staphylococcus aureus (MRSA).This LZD-resistant MRSA was isolated from a patient with mediastinitis only after LZD treatment had been administered for 14 days. The isolate was identified as SCCmec type II and multi-locus sequence type ST-5 with sec, seg, sei, and tst, which is the most common healthcare-associated MRSA in Japan. The LZD resistance was due to G2576 T mutation in three ribosomal genes, rrn1, rrn3, and rrn5. This strain showed a significantly elevated mutation rate in rifampin-resistance acquisition. The prevalence of such “hypermutator” MRSA strains should be monitored carefully.
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  • A Phantom Study to Evaluate an Optimum Acquisition Protocol for Coronary CTA in Patients with a Rapid Heart Rate : with Special Reference to Infants
    YOSUKE KOGURE, YUTAKA OZAKI, RYOHEI KUWATSURU
    2011 Volume 57 Issue 4 Pages 377-386
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.377
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    Objective: This study evaluated an optimum acquisition protocol for coronary CT angiography (CTA) in patients with a rapid heart rate. Materials and Methods: ECG-gated imaging was performed using a cardiac dynamics phantom and simulated blood vessels, setting the heart rate to 60-130 bpm. Differences between the stenosis rates measured on images and those in simulated blood vessels were analyzed statistically. Results: The error in the stenosis rate of simulated blood vessels increased as the heart rate elevated, the diameter of simulated vessels decreased, and the simulated stenosis rate and beam pitch (BP) increased. However, changes in the measurement error were not uniform, and there were no significant increases with elevations in the heart rate from 60 to 80 bpm or from 110 to 130 bpm. At a heart rate other than 80 bpm, the measurement error was not significantly different between the images acquired at the minimum BP and those at a 30% reduced radiation dose. Conclusions: The selection of an acquisition protocol that reduces image quality loss while minimizing the radiation dose may be possible by considering the heart rate, blood vessel size, and characteristics of the segment reconstruction method.
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  • Inhibitory effects of astragali radix on nitric oxide synthase in 5/6 nephrectomized rats with chronic renal failure
    HITOE TOYODA, MITSUO TANIMOTO, MASAKAZU MATSUMOTO, TOMOHITO GOHDA, SAT ...
    2011 Volume 57 Issue 4 Pages 387-394
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.387
    JOURNAL FREE ACCESS
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    Objective : It is generally considered that astragali radix, a common component of traditional herbal formulations, contributes to the treatment of various diseases. Although it has been reported that astragali radix improves the levels of serum creatinine in patients with chronic renal failure, the mechanism has not been fully clarified. Several studies have shown that renal injuries were associated with increased expression of nitric oxide synthase (NOS). In the present study, we investigated that the effects of astragali radix on NOS in 5/6 nephrectomized rats with chronic renal failure. Methods : At 8 weeks of age, 5/6 rats were nephrectomized and then, starting at 12 weeks of age, given astragali radix (10g/kg/day) in chow for 12 weeks. The animals were divided into 3 groups as follows : astragali radix-treated group (n=5), non-treated group (n=5) and non-nephrectomized control group (n=5). The urinary albumin/creatinine ratio (ACR), serum creatinine, blood urea nitrogen (BUN), creatinine clearance (CCr), urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), and body weights were measured as biochemical parameters. Sclerosis Index in glomeruli was evaluated by PAS staining. Protein expressions of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS) and nitrotyrosine in kidneys were evaluated by immunohistochemical analyses. Results : Astragali radix improved the levels of CCr, serum creatinine and BUN. There were no significant changes in body weight, levels of urinary ACR and urinary 8-OHdG among all groups. Sclerosis Index in glomeruli was decreased in the astragali radix-treated group compared with that in the nontreated group. Protein expressions of eNOS, iNOS and nitrotyrosine in glomeruli were significantly suppressed in the astragali radix-treated group. Conclusions : It appears that astragali radix ameliorated glomerulosclerosis in chronic renal failure. These effects might be related to tissue-specific activations of eNOS, iNOS and nitrotyrosine.
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  • Lightning strikes
    YOUICHI YANAGAWA, TOSHIAKI IBA
    2011 Volume 57 Issue 4 Pages 395-402
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.395
    JOURNAL FREE ACCESS
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    A lightning strike represents a high magnitude of energy, which has a short duration of exposure and a different current pathway compared to those causing electrical injury. Accordingly, if appropriate resuscitation is provided, even a patient with cardiopulmonary arrest can obtain a favorable outcome. However, it is important to use as much caution as possible to avoid being struck by lightning. Although predicting the occurrence of lightning injury has been considered difficult, this thought is changing. Advice for avoiding lightning injury has already been published by various organizations, and this advice is useful when judging whether outdoor recreation should continue or not. Seeing lightning or hearing thunder suggests that one is within the range of a potential lightning strike, and moving into a shelter, such as a fully enclosed metal vehicle, is therefore required.
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  • Prohibition on smoking within Juntendo University Hospital area
    -Cooperation with local community and changes in awareness of smoking-
    2011 Volume 57 Issue 4 Pages 403-412
    Published: August 31, 2011
    Released on J-STAGE: November 11, 2014
    DOIhttps://doi.org/10.14789/pjmj.57.403
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    A committee on the promotion of smoking cessation was established in January 2006 in Juntendo University School of Medicine and Juntendo University Hospital. The committee consisted of staff with various areas of expertise and included physicians, nurses, medical technicians, and office staff from the hospital and school. The mission of the committee was : 1) to ban smoking throughout the entire area of Hongo campus including the hospital and school in order to provide patients with high quality medical service in a smoke-free environment; 2) to promote smoking cessation; and 3) to educate the general public regarding the detrimental effects of smoking. To accomplish this mission, the committee planned and implemented various projects. For example, public relations programs targeting patients and employees at Juntendo, inviting only smoke-free taxis within hospital area, a patrol to clean up the area and neighborhood of Juntendo Hospital, regular publication of news on smoking-related health problems and the importance of smoking cessation, conducting a questionnaire-based survey on the awareness of smoking-related health problems the and importance of a smoke-free environment, cooperation with the local community to promote legislation for smoke-free public roads, and so on. Herein, we report what the committee has done for the past 5 years to accomplish this mission, how awareness of smoking-related health problems and the benefits of a smoke-free environment has changed among persons working in the Hongo campus area, and perspectives for the future direction.
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