著者

Margareta B Møller

出版者

The Keio Journal of Medicine

雑誌

The Keio Journal of Medicine (ISSN:00229717)

巻号頁・発行日

vol.40, no.3, pp.146-150, 1991 (Released:2009-03-27)

参考文献数

12

被引用文献数

5 7

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Some patients have vertigo that is more or less constant, associated with varying degrees of nausea, and only relieved by bedrest. This disorder, named disabling positional vertigo (DPV), was found to be caused by a blood vessel or vessels compressing the eighth cranial nerve in its intracranial portion, and it can be relieved by microvascular decompression (MVD) of the nerve. Important in the differential diagnosis of DPV are a detailed history, the results of audiometry (10 to 15 dB interaural threshold difference or a small mid-frequency notch), acoustic middle ear reflex response testing (may be abnormal), and recordings of brainstem auditory evoked potentials (BAEP). BAEP in such cases show increased conduction time in the auditory nerve and/or prolonged latency of wave V recorded from the contralateral ear, possibly the result of brainstem compression. Abnormalities on vestibular testing often do not reflect the severity of the illness. Forty-one patients who underwent MVD to treat DPV in one year at the author's institution have been followed for 4.5 to 5.5 years. By self-evaluation, 20 had excellent and 10 good results of the operation. The success of this procedure is even higher today, since it was found that very small blood vessels, including veins, can cause DPV; thus all vessels touching the nerve are now managed. Complications of MVD are rare. The most frequent, hearing loss, occurred in only one patient in this series.

著者

Yuji Sato Keisuke Koyama

出版者

The Keio Journal of Medicine

雑誌

The Keio Journal of Medicine (ISSN:00229717)

巻号頁・発行日

vol.59, no.3, pp.104-109, 2010-09-25 (Released:2010-10-01)

参考文献数

16

被引用文献数

2 7

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The volume of clinical research carried out in Japan is relatively small by global standards, especially when compared with the country's contributions to basic research. Although the academic quality of the clinical research done here is generally high, its relative paucity has had a number of alarming consequences, e.g., delays in the approval of important new drugs and medical devices caused by difficulties in clinical trials, leading to the limited availability of novel treatments for Japanese patients. This article aims to present an overview of current clinical research activities in Japan and to summarise the historical, socio-cultural and regulatory issues underlying the current situation. Suggestions are made as to how the present problems might be resolved and how a brighter future for clinical research might be achieved.

著者

Min-Ho Song Hidemichi Hamada Masaru Mimura

出版者

The Keio Journal of Medicine

雑誌

The Keio Journal of Medicine (ISSN:00229717)

巻号頁・発行日

vol.63, no.2, pp.34-38, 2014 (Released:2014-06-25)

参考文献数

23

被引用文献数

1

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It is sometimes difficult to distinguish late-life schizophrenia from senile dementia because elderly patients with schizophrenia can present in chronic remission and show gradual cognitive decline with aging. We aimed to elucidate the semiological characteristics of late-life chronic schizophrenia. Three patients aged between 60 and 66 years who were admitted to our hospital were included in this study. Detailed history taking and psychiatric interviews were performed and reviewed in the light of psychopathological semiology. Although the three patients with late-life schizophrenia showed significant cognitive decline on the Hasegawa dementia rating scale and their negative symptoms mimicked dementia, the following psychopathological characteristics clearly differentiated them from patients with senile dementia: (1) a shift of temporal organization toward the future with intact memory, (2) hypersensitivity, (3) ambivalent personal relationships, (4) systematic bodily delusions, and (5) an ante festum mindset. Identifying such clinical features of patients with late-life schizophrenia could be important for developing more effective pharmacotherapy and for providing appropriate psychotherapy.

著者

TAKASHI HAYASHI

出版者

The Keio Journal of Medicine

雑誌

The Keio Journal of Medicine (ISSN:00229717)

巻号頁・発行日

vol.14, no.3, pp.135-144, 1965 (Released:2009-03-27)

参考文献数

20

被引用文献数

2 7

著者

Jeffrey M. Friedman

出版者

The Keio Journal of Medicine

雑誌

The Keio Journal of Medicine (ISSN:00229717)

巻号頁・発行日

vol.60, no.1, pp.1-9, 2011-03-25 (Released:2011-04-05)

参考文献数

69

被引用文献数

30 92

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The cloning of the ob gene and its gene product, leptin, has led to the elucidation of a robust physiologic system that maintains fat stores at a relatively constant level. Leptin is a peptide hormone secreted by adipose tissue in proportion to its mass. Recessive mutations in the leptin gene are associated with massive obesity in mice and humans, establishing a genetic basis for obesity. Leptin circulates in blood and acts on the brain to regulate food intake and energy expenditure. When fat mass falls, plasma leptin levels fall, stimulating appetite and suppressing energy expenditure until fat mass is restored. When fat mass increases, leptin levels increase, suppressing appetite until weight is lost. This system maintains homeostatic control of adipose tissue mass. The discovery of leptin has advanced our understanding of metabolic disease in a number of respects. Its identification has revealed a new endocrine system regulating body weight. This system provides a means by which changes in nutritional state regulate other physiologic systems. A number of leptin deficiency syndromes that are treatable with leptin replacement have been identified. The majority of obese subjects are leptin resistant, which establishes that obesity is the result of hormone resistance. Leptin treatment results in weight loss in a subset of obese patients and can also synergize with other anti-obesity agents to reduce weight in the general population. Leptin provides an entry point for studying a complex human behavior. Finally, this research has established that there is a powerful biological basis for obesity, a fact that is (correctly) changing public perception about the pathogenesis of this medical condition.

著者

Brian M Strem Kevin C Hicok Min Zhu Isabella Wulur Zeni Alfonso Ronda E Schreiber John K Fraser Marc H Hedrick

出版者

The Keio Journal of Medicine

雑誌

The Keio Journal of Medicine (ISSN:00229717)

巻号頁・発行日

vol.54, no.3, pp.132-141, 2005 (Released:2006-06-20)

参考文献数

108

被引用文献数

370 719 692

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Tissue engineering offers considerable promise in the repair or replacement of diseased and/or damaged tissues. The cellular component of this regenerative approach will play a key role in bringing these tissue engineered constructs from the laboratory bench to the clinical bedside. However, the ideal source of cells still remains unclear and may differ depending upon the application. Current research for many applications is focused on the use of adult stem cells. The properties of adult stem cells that make them well-suited for regenerative medicine are (1) ease of harvest for autologous transplantation, (2) high proliferation rates for ex vivo expansion and (3) multilineage differentiation capacity. This review will highligh the use of adipose tissue as a reservoir of adult stem cells and draw conclusions based upon comparisons with bone marrow stromal cells.

著者

Barbro B Johansson

出版者

The Keio Journal of Medicine

雑誌

The Keio Journal of Medicine (ISSN:00229717)

巻号頁・発行日

vol.53, no.4, pp.231-246, 2004 (Released:2005-06-17)

参考文献数

238

被引用文献数

60 81

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Research during the last decades has greatly increased our understanding of brain plasticity, i.e. how neuronal circuits can be modified by experience, learning and in response to brain lesions. Currently available neuroimaging techniques that make it possible to study the function of the human brain in vivo have had an important impact. Cross-modal plasticity during development is demonstrated by cortical reorganization in blind or deaf children. Early musical training has lasting effects in shaping the brain. Albeit the plasticity is largest during childhood, the adult brain retains a capacity for functional and structural reorganization that earlier has been underestimated. Resent research on Huntington's disease has revealed the possibility of environmental interaction even with dominant genes. Scientifically based training methods are now being applied in rehabilitation of patients after stroke and trauma, and in the sensory retraining techniques currently applied in the treatment of focal hand dystonia as well as in sensory re-education after nerve repair in hand surgery. There is evidence that frequent participation in challenging and stimulating activities is associated with reduced cognitive decline during aging. The current concept of brain plasticity has wide implication for areas outside neuroscience and for all human life.