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Keio Journal of Medicine

Yoshiyasu Aizawa, Yoko Tanimoto, Yoshiko Hirata, Taishi Fujisawa, Ryoma Fukuoka, Kazuaki Nakajima, Yoshinori Katsumata, Takahiko Nishiyama, Takehiro Kimura, Shinsuke Yuasa, Takashi Kohno, Shun Kohsaka, Mitsushige Murata, Yuichiro Maekawa, Yoshiko Furukawa, Seiji Takatsuki, Keiichi Fukuda
Some patients with hypertrophic cardiomyopathy (HCM) develop systolic dysfunction, called the dilated phase of HCM (d-HCM), which is associated with increased morbidity and mortality. We conducted a retrospective study using an HCM database to clarify the incidence, clinical characteristics, and long-term outcomes of d-HCM. We analyzed an HCM cohort consisting of 434 patients (273 with apical HCM and 161 with non-apical HCM; 18 had obstructive HCM, 16 had dilated HCM, and 127 had other HCM) diagnosed by echocardiography in our hospital between 1991 and 2010...
December 29, 2018: Keio Journal of Medicine
Hiroko Hozawa, Ayano Takeuchi, Yuko Oguma
This cross-sectional study investigated the associations of business type with the prevalence of metabolic syndrome (MetS) and lifestyle characteristics among workers in small- and medium-sized enterprises. In total, data from 167,736 workers (114,746 men and 52,990 women) who participated in health checkups in 2013 were analyzed using multilevel logistic regression models. The odds ratios (ORs) of having MetS, defined based on the criteria of the joint interim statement, were significantly higher in employees of transportation businesses (reference OR =1) than in other business types among men (OR: 0...
December 14, 2018: Keio Journal of Medicine
Masahiro Katsumata, Koichi Oki, Naoki Tsukada, Takato Abe, Yoshiaki Itoh, Shinichi Takahashi, Norihiro Suzuki
Previous reports have suggested that direct oral anticoagulants exert a prothrombolytic effect against intracardiac thrombi. We hypothesized that these anticoagulants may also help recanalize occluded intracranial arteries via prothrombolytic effects. In this study, we evaluated the effects of rivaroxaban, a direct oral anticoagulant, on fibrin emboli within the cerebrocortical microvessels in a mouse model of embolic stroke. Fibrin emboli prepared ex vivo were injected into the common carotid artery of male C57BL/6 mice, and embolization in the microvessels on the brain surface was observed through a cranial window...
November 30, 2018: Keio Journal of Medicine
Hideyuki Kondo, Takashi Okabe, Yoshitaka Okada, Takahiro Hasebe, Suguru Shirotake, Masafumi Oyama, Koshiro Nishimoto
Renal oncocytoma is generally regarded as a benign renal tumor. We herein report a case of large renal oncocytoma with renal venous tumor thrombus. The patient may need to be carefully followed up because hematogenous metastasis may occur.
November 23, 2018: Keio Journal of Medicine
Yuka Yamada, Takashi Yurikusa, Kohei Furukawa, Yasuhiro Tsubosa, Masahiro Niihara, Keita Mori, Seiji Asoda, Hiromasa Kawana, Yuko Kitagawa, Taneaki Nakagawa
Radical esophagectomy for thoracic esophageal cancer is invasive and frequently results in postoperative pulmonary complications. Postoperative pneumonia is the most common such complication and affects hospital mortality and survival rates. Oral care has been very effective in reducing pneumonia. In Japan, preoperative professional oral care is highly recommended. However, there are few studies on the effect of preoperative improvements in oral hygiene as a result of intervention on the incidence of postoperative pneumonia...
October 6, 2018: Keio Journal of Medicine
Daisuke Fujisawa
Depression is common among cancer patients and their families, and may lead to substantial clinical consequences. Clinicians should routinely screen cancer patients for comorbid depression and should provide appropriate care at both primary and specialized care levels. Good quality care is beneficial not only for cancer patients themselves but also for their family members. It includes good communication between patients and health providers, and addressing of unmet needs of cancer patients. Specialized care comprises pharmacotherapy and psychotherapy...
September 25, 2018: Keio Journal of Medicine
Hajime Iwasawa, Tomoaki Nishimura, Shota Nemoto, Naoki Aikawa, Kiyoaki Watanabe
In this study, we investigated the correlations between biochemical and hematological test results obtained using microliter-scale fingertip blood samples collected with a newly developed blood collection device and those obtained using conventional venous blood. Eighty volunteer subjects were enrolled in this study. Blood samples were drawn from the fingertip of the ring finger by a single puncture, and 60-µL samples were promptly and accurately aspirated into a blood collection chip. Then the chip was tightly sealed in a chip container and was shaken to mix the contents without dispersion...
June 25, 2018: Keio Journal of Medicine
Takuji Iwamoto, Hiroyasu Ikegami, Taku Suzuki, Satoshi Oki, Noboru Matsumura, Masaya Nakamura, Morio Matsumoto, Kazuki Sato
Unlinked total elbow arthroplasty (TEA), which has no mechanical connection between the humeral and ulnar components, has theoretical advantages based on its near-normal elbow kinematics and the preservation of bone stock. Unlinked TEA is appropriate only for patients who have limited bone loss or limited deformity and good ligamentous function. This is because postoperative instability has been a major complication of unlinked prostheses. The concept and goal of unlinked TEA is to share the loading stress on the bone implant interface with the surrounding tissues...
June 25, 2018: Keio Journal of Medicine
Naritaka Kimura
Congenital heart disease (CHD) is the most common birth defect, affecting 1 in 100 babies. Among CHDs, single ventricle (SV) physiologies, such as hypoplastic left heart syndrome and tricuspid atresia, are particularly severe conditions that require multiple palliative surgeries, including the Fontan procedure. Although the management strategies for SV patients have markedly improved, the prevalence of ventricular dysfunction continues to increase over time, especially after the Fontan procedure. At present, the final treatment for SV patients who develop heart failure is heart transplantation; however, transplantation is difficult to achieve because of severe donor shortages...
June 19, 2018: Keio Journal of Medicine
Jumpei Sasabe, Masataka Suzuki
Living organisms enantioselectively employ L-amino acids as the molecular architecture of protein synthesized in the ribosome. Although L-amino acids are dominantly utilized in most biological processes, accumulating evidence points to the distinctive roles of D-amino acids in non-ribosomal physiology. Among the three domains of life, bacteria have the greatest capacity to produce a wide variety of D-amino acids. In contrast, archaea and eukaryotes are thought generally to synthesize only two kinds of D-amino acids: D-serine and D-aspartate...
May 22, 2018: Keio Journal of Medicine
Kosuke Tajima, Chikako Shimizu, Soichiro Ohno, Yusho Nishida, Kazuhiko Udagawa, Junichi Sasaki
The suprapatellar approach for intramedullary tibial nailing has become widely accepted over the past decade. A round sleeve is passed beneath the patella to protect the surface of the patellofemoral joint (PFJ). However, the round sleeve cannot be easily stabilized in the PFJ because it does not conform to the shape of the patellar apex. Consequently, we produced a heart-shaped sleeve to simplify the insertion of the entry sleeve during the suprapatellar approach. Using the new sleeve, the following procedure is used: (1) make a longitudinal 4 cm skin incision proximal to the patella to reach the PFJ, (2) insert the guide pin manually to the ventral edge of the tibial plateau, (3) insert the cannulated trocar along the guide pin, (4) insert the heart-shaped sleeve along the cannulated trocar, (5) remove the cannulated trocar, (6) ream the entry point through the heart-shaped sleeve...
March 23, 2018: Keio Journal of Medicine
Toshihide Kurihara
The hypoxia response is a fundamental phenomenon mainly regulated by hypoxia-inducible factors (HIFs). For more than a decade, we have investigated and revealed the roles of the hypoxia response in the development, physiology, and pathophysiology of the retina by generating and utilizing cell-type-specific conditional knockout mice. To investigate the functions of genes related to the hypoxia response in cells composing the retina, we generated various mouse lines that lack HIFs and/or related genes specifically in retinal neurons, astrocytes, myeloid cells, or retinal pigment epithelium cells...
March 23, 2018: Keio Journal of Medicine
Yuji Otsuki, Hirofumi Konn, Keisa Takeda, Masahiko Koike
Obturator hernia (OH) is a rare condition that accounts for 0.073-1% of abdominal hernias and 0.48% of bowel obstructions. OH frequently occurs in elderly women, with an incidence that increases with age. The only treatment for OH is surgical intervention, and the approaches used vary greatly. Consequently, a well-defined consensus has not yet emerged. We assessed the efficiency and safety of the midline extraperitoneal approach for OH. Six patients with OH repaired using the midline extraperitoneal approach at KKR Sapporo Medical Center between April 2011 and January 2016 were included in the study...
March 14, 2018: Keio Journal of Medicine
Daigo Ochiai, Hirotaka Masuda, Yushi Abe, Toshimitsu Otani, Marie Fukutake, Tadashi Matsumoto, Kei Miyakoshi, Mamoru Tanaka
Mesenchymal stem cells (MSCs) have generated great interest in the fields of regenerative medicine and immunotherapy because of their unique biological properties. Among MSCs, amniotic fluid stem cells (AFS) have a number of characteristics that make them attractive candidates for tissue engineering and cell replacement strategies, particularly for perinatal medicine. If various neonatal conditions, including birth asphyxia, preterm birth, and congenital abnormalities, which result in long-lasting severe impairments, could be predicted during pregnancy, it would allow collection of small samples of amniotic fluid cells by amniocentesis...
March 6, 2018: Keio Journal of Medicine
Yuka Ota, Naoki Ozeki, Kenya Yuki, Daisuke Shiba, Itaru Kimura, Kazushige Tsunoda, Kei Shinoda, Hisao Ohde, Kazuo Tsubota
The aim of this study was to evaluate the effects of transcorneal electrical stimulation in subjects with primary open-angle glaucoma. Five eyes of four male subjects with primary open-angle glaucoma (average age: 52.25 ± 14.68 years) were enrolled. The subjects underwent transcorneal electrical stimulation every 3 months according to the following procedure. A Dawson-Trick-Litzkow electrode was placed on the cornea, and biphasic electric current pulses (10 ms, 20 Hz) were delivered using a stimulator (BPG-1,BAK Electronics) and a stimulus isolation unit (BSI-2)...
February 7, 2018: Keio Journal of Medicine
Masumi Ueda
Graft-versus-host disease (GVHD) is a major contributor to early and late morbidity and mortality after allogeneic stem cell transplantation. Despite results from a randomized controlled trial demonstrating an increased risk of chronic GVHD with use of growth factor-mobilized peripheral blood stem cells (PBSC) compared with bone marrow, PBSCs are the most widely used graft source in allogeneic transplantation for hematologic neoplasms in the U.S. This lecture will review established, recent, and novel strategies for GVHD prevention in unrelated donor PBSC transplantation and will highlight ongoing clinical research at Fred Hutchinson Cancer Research Center...
2018: Keio Journal of Medicine
Toru Hifumi, Akihiko Yamamoto, Manabu Ato, Kyoko Sawabe, Kazunori Morokuma, Nobuya Morine, Yutaka Kondo, Eiichiro Noda, Atsushi Sakai, Jin Takahashi, Kazuo Umezawa
Blood serum from immunized humans or animals (e.g., horses) contains relevant antibodies and has been used as serum therapy to treat many diseases or envenomation events. The effectiveness of blood serum was initially discovered in 1890 when Kitasato and von Behring observed the effectiveness of this type of therapy against diphtheria and tetanus. Serum therapies played an important role in the advancement of modern medicine prior to the development of penicillin and steroids. At present, several types of serum therapy remain in clinical use...
December 25, 2017: Keio Journal of Medicine
Keitaro Watanabe, Takeo Kosaka, Hiroshi Hongo, Satoshi Tamaki, Mototsugu Oya
We describe the case of a 55-year-old man who underwent four cycles of cabazitaxel therapy for castration-resistant prostate cancer (CRPC). After the fourth cycle of cabazitaxel, the patient experienced severe headaches. Brain gadolinium (Gd) contrast-enhanced magnetic resonance imaging (MRI) revealed multiple brain metastases. A few days later, the patient suffered impaired consciousness that progressed rapidly. The patient was treated for the symptoms of increased intracranial pressure and underwent whole-brain radiation...
December 25, 2017: Keio Journal of Medicine
Satoru Yamada
Currently, the low-energy diet is the only recognized nutrition therapy for type 2 diabetes in Japan. However, in recent decades, many foreign scientific organizations have accepted various nutritional approaches to manage diabetes, such as the low-carbohydrate diet, the Mediterranean diet, diet approaches to stop hypertension (DASH), and the vegetarian diet. Moreover, growing evidence has called into question classical nutritional approaches such as the low-fat diet for the prevention of cardiovascular disease and the low-protein diet for the prevention of diabetic kidney disease...
September 26, 2017: Keio Journal of Medicine
Dai Kamamoto, Satoshi Takahashi, Kazunari Yoshida
No abstract text is available yet for this article.
September 26, 2017: Keio Journal of Medicine
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