Kowa H
Department of Neurology, Kitasato University East Hospital.
Rinsho Shinkeigaku. 1997 Dec;37(12):1079-87.
It was one of the great pleasures to have fulfilled my long-held dream in 1986, newly opened the Kitasato University East Hospital (KUEH). In 1965, I served at chronic ward of Baltimore City Hospitals as a resident of neurology, where most of the patients were relaxed and enjoyed their hospital life. Since then, my dream had been growing that chronic ward for neurological diseases was necessary in Japan, good for chronic cares as well as clinical research. KUEH include 89 beds for neurological diseases, uniquely enough, of which 15 beds specially prepared for the patients with respiratory distress suffering from intractable neurological diseases. KUEH gave us a lot of medical informations, developed to clinical research. Some of them will be introduced briefly as follows; firstly, in three patients with Guillain-Barré syndrome (GBS) we found high titers of serum IgM and IgG antibodies associated with acute cytomegalovirus (CMV) infections. They also had high titers of IgM and IgG anti-GM2 antibodies. The titers of anti-GM2 antibodies decreased on absorption with CMV-infected cells. These new findings suggested that anti-GM2 antibodies are associated with acute CMV infections in GBS patients. Secondly, we have patients with autosomal dominant familial Parkinsonism in Sagamihara, Kanagawa. Their clinical features are not essentially different from solitary Parkinson disease, and they respond well to levodopa treatment. Three autopsied cases, however, revealed neuropathological findings much different from those of classical Parkinson disease, such as rather mild to moderate loss of melanin-containing cells, well-maintained locus ceruleus neurons in number and no Lewy bodies detected at all. There are no reports in literatures of familial Parkinsonism from clinical and neuropathological points of view. Thirty-eight years have passed since establishment of the Japan Neurological Society, meanwhile the expertise neurologists come out. Neurology is, however, still minor in medical practice. This is my opinion that neurologist should take leadership in clinical medicine as well as in academic fields. We need tell people our work, how our neurologic expertise can help them treat various disorders such as stroke, pain, sleep, and headache, epilepsy as well as physical and mental rehabilitation for the establishment of our identity.
1986年，北里大学东医院（KUEH）新开业，实现了我长久以来的梦想，这是一大乐事。1965年，我作为神经科住院医师在巴尔的摩市医院的慢性病病房工作，那里的大多数患者都很放松，享受着他们的医院生活。从那时起，我就一直梦想着在日本建立一个神经疾病慢性病病房，这对慢性病护理和临床研究都有好处。KUEH有89张神经疾病床位，特别的是，其中15张床位是专门为患有难治性神经疾病且有呼吸窘迫的患者准备的。KUEH为我们提供了大量医学信息，并开展了临床研究。其中一些将简要介绍如下：首先，在3例吉兰-巴雷综合征（GBS）患者中，我们发现与急性巨细胞病毒（CMV）感染相关的血清IgM和IgG抗体滴度很高。他们的IgM和IgG抗GM2抗体滴度也很高。抗GM2抗体滴度在与CMV感染细胞吸附后降低。这些新发现表明抗GM2抗体与GBS患者的急性CMV感染有关。其次，我们有来自神奈川县相模原市的常染色体显性遗传性帕金森病患者。他们的临床特征与散发性帕金森病本质上没有区别，对左旋多巴治疗反应良好。然而，3例尸检病例显示神经病理学发现与经典帕金森病有很大不同，如含黑色素细胞的丢失相当轻微至中度，蓝斑核神经元数量保持良好，根本未检测到路易小体。从临床和神经病理学角度来看，文献中没有关于家族性帕金森病的报道。日本神经学会成立至今已有38年，同时出现了专业的神经科医生。然而，神经学在医学实践中仍然不太受重视。我的观点是，神经科医生应该在临床医学以及学术领域发挥领导作用。我们需要向人们介绍我们的工作，即我们的神经学专业知识如何帮助他们治疗各种疾病，如中风、疼痛、睡眠、头痛、癫痫以及身心康复，以确立我们的身份。
