Pakhawadee Palungwachira, Cattleya Bundit, Chutirut Vatcharothayangul, S. Churproong, Y. Sumi, Yoichi Yanagawa, T. Iba, Hiroshi Tanaka
*1)Chulalongkorn University Hospital, Bangkok, Thailand, *2)Mahidol University Siriraj Hospital, Bangkok, Thailand, *3)Suranaree University of Technology, Nakhon Ratchasima, Thailand, *4)Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan, *5)Department of Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan, *6)Department of Emergency Medicine & Disaster Medicine, Juntendo University Hospital, Tokyo, Japan
{"title":"Clinical Elective Study Report at the Department of Emergency and Critical Care Medicine in Juntendo University Faculty of Medicine","authors":"Pakhawadee Palungwachira, Cattleya Bundit, Chutirut Vatcharothayangul, S. Churproong, Y. Sumi, Yoichi Yanagawa, T. Iba, Hiroshi Tanaka","doi":"10.14789/JMJ.61.166","DOIUrl":"https://doi.org/10.14789/JMJ.61.166","url":null,"abstract":"*1)Chulalongkorn University Hospital, Bangkok, Thailand, *2)Mahidol University Siriraj Hospital, Bangkok, Thailand, *3)Suranaree University of Technology, Nakhon Ratchasima, Thailand, *4)Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba, Japan, *5)Department of Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan, *6)Department of Emergency Medicine & Disaster Medicine, Juntendo University Hospital, Tokyo, Japan","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115460364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Minimally invasive surgery is drawing interest for the management of patients with pancreatic disease. This is especially the case for patients with benign and low-grade malignant lesions of the pancreatic tail, efficiently treated by laparoscopy. The laparoscopic management of patients with pancreatic head lesions remains technically more challenging, but the use of robot-assisted surgery has the potential to facilitate their resection. This article reviews the recent advances in minimally invasive pancreas surgery.
{"title":"Recent Progress in Minimally Invasive Pancreas Surgery","authors":"T. Kawahara, C. Toso, H. Furukawa","doi":"10.14789/JMJ.61.126","DOIUrl":"https://doi.org/10.14789/JMJ.61.126","url":null,"abstract":"Minimally invasive surgery is drawing interest for the management of patients with pancreatic disease. This is especially the case for patients with benign and low-grade malignant lesions of the pancreatic tail, efficiently treated by laparoscopy. The laparoscopic management of patients with pancreatic head lesions remains technically more challenging, but the use of robot-assisted surgery has the potential to facilitate their resection. This article reviews the recent advances in minimally invasive pancreas surgery.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128729458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shiyue He, Kazuo Kempe, Y. Tomiki, M. Nishizuka, Tsutomu Suzuki, T. Dambara, Takao Okada
*1) Department of Medical Education, Juntendo University Graduate School of Medicine, Tokyo, Japan, *2) Division of Rheumatology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, *3)Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan, *4) Department of Cell Biology and Neuroscience, Juntendo University Faculty ofMedicine, Tokyo, Japan, *5)Division of RespiratoryMedicine, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, *6)Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, *7)Department of Physiology (II), Juntendo University Faculty of Medicine, Tokyo, Japan
{"title":"Correlations Between Entrance Examination Scores and Academic Performance Following Admission","authors":"Shiyue He, Kazuo Kempe, Y. Tomiki, M. Nishizuka, Tsutomu Suzuki, T. Dambara, Takao Okada","doi":"10.14789/JMJ.61.142","DOIUrl":"https://doi.org/10.14789/JMJ.61.142","url":null,"abstract":"*1) Department of Medical Education, Juntendo University Graduate School of Medicine, Tokyo, Japan, *2) Division of Rheumatology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, *3)Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan, *4) Department of Cell Biology and Neuroscience, Juntendo University Faculty ofMedicine, Tokyo, Japan, *5)Division of RespiratoryMedicine, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, *6)Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, *7)Department of Physiology (II), Juntendo University Faculty of Medicine, Tokyo, Japan","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129976329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michio Machida, Y. Kajiyama, K. Kojima, T. Kitabatake, Ikuo Watanobe, S. Miyano
In recent years, laparoscopy-assisted distal gastrectomy (LADG) has become widely used for the treatment of early gastric cancer. In our hospital, LADG has been performed in 53 patients since it was adopted in November 2006. In the present study, we compared 45 of these LADG patients with T1N0M0 stage IA early gastric cancer and 49 patients who underwent open distal gastrectomy (ODG) during the same period for cancer of the same stage. The compared outcomes included operative time, bleeding loss, and number of lymph node dissections, which reflected the surgical outcomes, as well as the times to first water intake, oral intake, flatus, and bowel movement, and blood test results white blood cell (WBC), C-reactive protein (CRP), which reflected the postoperative course. The length of postoperative hospital stay and complications were also compared. There were no significant differences in operative time or number of lymph node dissections between the groups, although blood loss was significantly lesser with LADG (p<0.05). There were no significant differences in postoperative course between the 2 groups. These findings suggest that LADG can be performed with the same level of safety as conventional ODG in cases of stage IA gastric cancer and that it may be recommended as the standard operative procedure in these patients.
{"title":"Comparison of Laparoscopy-Assisted Distal Gastrectomy and Open Distal Gastrectomy for Early Gastric Cancer","authors":"Michio Machida, Y. Kajiyama, K. Kojima, T. Kitabatake, Ikuo Watanobe, S. Miyano","doi":"10.14789/JMJ.61.158","DOIUrl":"https://doi.org/10.14789/JMJ.61.158","url":null,"abstract":"In recent years, laparoscopy-assisted distal gastrectomy (LADG) has become widely used for the treatment of early gastric cancer. In our hospital, LADG has been performed in 53 patients since it was adopted in November 2006. In the present study, we compared 45 of these LADG patients with T1N0M0 stage IA early gastric cancer and 49 patients who underwent open distal gastrectomy (ODG) during the same period for cancer of the same stage. The compared outcomes included operative time, bleeding loss, and number of lymph node dissections, which reflected the surgical outcomes, as well as the times to first water intake, oral intake, flatus, and bowel movement, and blood test results white blood cell (WBC), C-reactive protein (CRP), which reflected the postoperative course. The length of postoperative hospital stay and complications were also compared. There were no significant differences in operative time or number of lymph node dissections between the groups, although blood loss was significantly lesser with LADG (p<0.05). There were no significant differences in postoperative course between the 2 groups. These findings suggest that LADG can be performed with the same level of safety as conventional ODG in cases of stage IA gastric cancer and that it may be recommended as the standard operative procedure in these patients.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130642930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laparoscopic liver resection (LLR) has several advantages over conventional open liver surgery. However, the indications for laparoscopic liver resection remain limited because of technical difficulties, hemorrhagic and embolic risks, and the suspicion of oncological inadequacy. The number of publications on this topic has significantly increased in recent years, and they show that LLR is becoming the standard approach for patients with liver tumors. Although potential good candidates for LLR are patients with peripheral lesions requiring limited hepatectomy or left lateral sectionectomy, the indications for LLR have recently been extended to major hepatectomy in well-experienced centers. We provide a comprehensive review of LLR, focusing on the types of resection, technical approaches, and collective morbidity and mortality according to the literature presently available. LLR, which is a complex procedure requiring experience in both laparoscopic technique and conventional liver surgery, is safe and feasible with careful patient selection.
{"title":"Laparoscopic Major Liver Resection","authors":"K. Uchida, C. Sonia, T. Kawahara","doi":"10.14789/JMJ.61.116","DOIUrl":"https://doi.org/10.14789/JMJ.61.116","url":null,"abstract":"Laparoscopic liver resection (LLR) has several advantages over conventional open liver surgery. However, the indications for laparoscopic liver resection remain limited because of technical difficulties, hemorrhagic and embolic risks, and the suspicion of oncological inadequacy. The number of publications on this topic has significantly increased in recent years, and they show that LLR is becoming the standard approach for patients with liver tumors. Although potential good candidates for LLR are patients with peripheral lesions requiring limited hepatectomy or left lateral sectionectomy, the indications for LLR have recently been extended to major hepatectomy in well-experienced centers. We provide a comprehensive review of LLR, focusing on the types of resection, technical approaches, and collective morbidity and mortality according to the literature presently available. LLR, which is a complex procedure requiring experience in both laparoscopic technique and conventional liver surgery, is safe and feasible with careful patient selection.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131127732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Islet Transplantation for Type 1 Diabetes","authors":"B. Gala-Lopez, T. Kawahara, A. Pepper, A. Shapiro","doi":"10.14789/JMJ.61.131","DOIUrl":"https://doi.org/10.14789/JMJ.61.131","url":null,"abstract":"","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121164455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Iwase, Y. Shimura, M. Sawa, H. Nojiri, Y. Makino, M. Tsuchiya, K. Aritomi, K. Kaneko, H. Kurosawa
Objective: To determine whether or not there is a correlation between the severity of hand osteoarthritis (OA) and low bone mineral density (BMD). Materials: In 30 patients with hand OA who attended our department with chief complaint of arthralgia in the fingers, data on BMD and the radiographic severity of hand OA were statistically analyzed. Of the 30 subjects studied, 24 were females and 6 males. All subjects aged between 49 and 85 years (mean: 70.0 years). They consisted of 18 subjects with Heberdenʼs nodes, 8 with Bouchardʼs nodes, and 9 with rhizarthrosis. Methods: Radiographic severity of hand OA was scored with the Kellgren/Lawrence scale (grade 0-4). BMD of vertebral bodies was measured by dual-energy X-ray absorptiometry. Results: A statistically significant correlation was found between the radiographic severity of Heberdenʼs nodes and low BMD, whereas neither rhizarthrosis nor Bouchardʼs nodes showed any correlation between radiographic severity and BMD. Conclusions: A statistically significant correlation between the radiographic severity of hand OA and BMD was established solely for Heberdenʼs nodes. Although low BMD may influence the progression of hand OA, there may also be other influencing factors.
{"title":"Association between Radiographic Severity of Osteoarthritis of Finger Joints and Bone Mineral Density","authors":"Y. Iwase, Y. Shimura, M. Sawa, H. Nojiri, Y. Makino, M. Tsuchiya, K. Aritomi, K. Kaneko, H. Kurosawa","doi":"10.14789/JMJ.61.29","DOIUrl":"https://doi.org/10.14789/JMJ.61.29","url":null,"abstract":"Objective: To determine whether or not there is a correlation between the severity of hand osteoarthritis (OA) and low bone mineral density (BMD). Materials: In 30 patients with hand OA who attended our department with chief complaint of arthralgia in the fingers, data on BMD and the radiographic severity of hand OA were statistically analyzed. Of the 30 subjects studied, 24 were females and 6 males. All subjects aged between 49 and 85 years (mean: 70.0 years). They consisted of 18 subjects with Heberdenʼs nodes, 8 with Bouchardʼs nodes, and 9 with rhizarthrosis. Methods: Radiographic severity of hand OA was scored with the Kellgren/Lawrence scale (grade 0-4). BMD of vertebral bodies was measured by dual-energy X-ray absorptiometry. Results: A statistically significant correlation was found between the radiographic severity of Heberdenʼs nodes and low BMD, whereas neither rhizarthrosis nor Bouchardʼs nodes showed any correlation between radiographic severity and BMD. Conclusions: A statistically significant correlation between the radiographic severity of hand OA and BMD was established solely for Heberdenʼs nodes. Although low BMD may influence the progression of hand OA, there may also be other influencing factors.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"167 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133476584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Yuasa, Y. Shirayama, Ryoko Nishida, Rie Sayama, Kiyoko Ikegami, E. Marui
{"title":"Why Maternal Mortality Ratio (MMR) Reduction Was Selected as One of the Eight Priority Targets in the Millenium Development Goals (MDGs)","authors":"M. Yuasa, Y. Shirayama, Ryoko Nishida, Rie Sayama, Kiyoko Ikegami, E. Marui","doi":"10.14789/JMJ.61.49","DOIUrl":"https://doi.org/10.14789/JMJ.61.49","url":null,"abstract":"","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121219997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the course of my anesthesiology career, I have noticed that volatile anesthetics have shown remarkable improvement with the introduction of sevoflurane. Inhaled sevoflurane allows a particularly smooth and quick induction, in addition to providing stable anesthetic maintenance. Another improvement has been the development of the synthetic opioid remifentanil. Because it undergoes degradation within a few minutes, there is no risk of respiratory depression after discontinuing drug administration. Remifentanil also depresses sympathetic activity centrally, which provides cardiovascular stability during anesthesia, and as a result, it is utilized in many different surgeries. For patients with a difficult airway, the development of the laryngeal mask airway has proven to be quite useful as it greatly eases management. Several types of laryngeal mask airway have been investigated and, with a few notable contraindications such as a full stomach and severe obesity, it is widely employed worldwide. In pediatric anesthesia, the most interesting advance has been the use of caudal anesthesia employing local anesthetics and select analgesics. Combining dexmedetomidine or clonidine rather than morphine with the caudal anesthetic agent prolongs the analgesic duration without generating major adverse effects.
{"title":"The Advances in Anesthesiology During My Time at Juntendo University","authors":"Y. Kamiyama","doi":"10.14789/JMJ.60.178","DOIUrl":"https://doi.org/10.14789/JMJ.60.178","url":null,"abstract":"Over the course of my anesthesiology career, I have noticed that volatile anesthetics have shown remarkable improvement with the introduction of sevoflurane. Inhaled sevoflurane allows a particularly smooth and quick induction, in addition to providing stable anesthetic maintenance. Another improvement has been the development of the synthetic opioid remifentanil. Because it undergoes degradation within a few minutes, there is no risk of respiratory depression after discontinuing drug administration. Remifentanil also depresses sympathetic activity centrally, which provides cardiovascular stability during anesthesia, and as a result, it is utilized in many different surgeries. For patients with a difficult airway, the development of the laryngeal mask airway has proven to be quite useful as it greatly eases management. Several types of laryngeal mask airway have been investigated and, with a few notable contraindications such as a full stomach and severe obesity, it is widely employed worldwide. In pediatric anesthesia, the most interesting advance has been the use of caudal anesthesia employing local anesthetics and select analgesics. Combining dexmedetomidine or clonidine rather than morphine with the caudal anesthetic agent prolongs the analgesic duration without generating major adverse effects.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"210 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113991595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Therapeutic Targeting of Microenvironmental Interactions in Leukemia","authors":"Y. Tabe","doi":"10.14789/JMJ.60.156","DOIUrl":"https://doi.org/10.14789/JMJ.60.156","url":null,"abstract":"","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133870527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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