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Volume 192 (2000)
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- Issue 3 Pages 165-
- Issue 2 Pages 99-
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Volume 192, Issue 1
September
Displaying 1-9 of 9 articles from this issue
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Reviews
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Makoto Yamamuro, Kiyoshi Kusaka, Masato Kato, Masahiko Takahashi2000 Volume 192 Issue 1 Pages 1-18
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSThe neurolytic celiac plexus block (NCPB) has been recommended for pain relief in patients with upper abdominal cancer by the WHO Cancer Pain Relief Program. In this article, we review the indications, techniques, and adverse effects of NCPB based on the previous findings in the literature and our own experience of 142 NCPBs during the past 11 years. No well-validated indication criteria for the NCPB have been available from invasive trials or non-invasive pain evaluations. Thus, the procedure has been employed using comprehensive pain assessment. Several modified approaches have been described for NCPB with differences in the target space where the alcohol is injected (precrural and retrocrural) and the insertion route of the needle (posterolateral and transdiscal). We have used the retrocrural transdiscal approach because of its simplicity and safety. The efficacy of the resultant pain relief does not differ among these techniques. Therefore, whether a distinction exists between blocks of the celiac plexus and those of the splanchnic nerves is controversial. The term “peri-aortic nerve block” may better describe the feature of this neurolytic intervention. The noteworthy adverse effects of alcoholic neurolysis include regional pain, hypotension, diarrhea, hypoxemia, and acute alcoholic intoxication. Most of them are transient and controllable. The diarrhea may counteract the morphine-induced constipation. NCPB relieves visceral pain in upper abdominal cancer with no serious adverse effects. We recommend this procedure to improve the quality of life of the patients suffering from abdominal cancer pain.View full abstractDownload PDF (2262K) -
Mitsunobu Matsubara2000 Volume 192 Issue 1 Pages 19-33
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSRecent advances in genetic determination of human essential hypertension (EHT) are discussed by reviewing the candidate genes. Candidate genes have been selected based on genetic information from classical linkage analysis (affected sib-pair analysis) or mendelian hypertension (autosomal dominant inheritance of hypertension). Most of these genes are, directly or indirectly, coupled to salt handling of the kidney, being included in the renin-angiotensin system (RAS), steroid-hormone metabolism, and renal sodium transporters. Angiotensinogen (AGT) gene in RAS was first described as a strong candidate associated with the onset of hypertension, since sib-pair linkage analysis has demonstrated the trait loci for hypertension which includes the coding region for AGT. M235T polymorphism of AGT has been studied extensively in many populations including Japanese, and the results suggest a weak, but significant linkage with hypertension. The presence (insertion [I]) or absence (deletion [D]) of 287 bp in intron 16 of angiotensin converting enzyme gene has also been examined in RAS, and the results suggest D polymorphism as a risk factor for hypertension in men. Other components in RAS, such as renin, angiotensinogen II type I receptor, or kallikrein have also been studied, but the available information is still incomplete. Genetic investigations of mendelian hypertension has identified the genetic mechanisms for glucocorticoid remediable aldosteronism, apparent mineral corticoid excess, and Liddle's syndrome as chimeric gene duplications of CYP11B1 (aldosterone synthase gene) and CYP11B2 (11β-hydroxylase gene), mutations in the gene of 11β-hydroxysteroid dehydrogenase type 2 that catalyzes the conversion of cortisol to cortisone, and mutations in β or γ subunit of epithelial sodium channel (ENaC), respectively. Subsequently, genetic variants of CYP11B2 and β or γ subunit of ENaC have been found, suggesting the -344C polymorphism of CYP11B2, 594S variant of βENaC, and two rare variants of γENaC as risk factors for EHT. In spite of the extensive research, haplotypes in individual populations remain to be elucidcated in most candidate genes. Even casual conclusions of possible linkage with EHT need to be further examined with better determinations of phenotypes, such as ambulatory and home blood pressure monitoring or identification of onset of hypertension in cohort studies.View full abstractDownload PDF (996K)
Regular Contributions
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Juro Iriuchijima2000 Volume 192 Issue 1 Pages 35-40
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSThe presence of an abnormal sympathetic vascular tone is assumed in the hindquarters of spontaneously hypertensive rats (SHR) on the basis that ganglionic blockade decreases hindquarter vascular resistance (HQR) in them but not in normotensive control rats (NCR). Hindquarter blood flow (HQF) was observed with an electromagnetic flow probe implanted around the terminal aorta in SHR and NCR in the conscious state. Mean arterial pressure (AP) was also recorded with an indwelling catheter. HQR was calculated as AP divided by HQF. Intravenous bolus injection of chlorpromazine-HCl at 0.5 mg/kg significantly decreased HQR in SHR but not in NCR. Thereafter, in SHR, ganglionic blockade with hexamethonium bromide did not decrease HQR further. Chlorpromazine given to SHR after ganglionic blockade did not decrease HQR either. These findings indicate that the abnormal hindquarter tone in SHR was inhibited by chlorpromazine. It is suggested that dopaminergic neurons are involved in the hindquarter sympathetic tone generation.View full abstractDownload PDF (303K) -
Seung-Moo Han2000 Volume 192 Issue 1 Pages 41-48
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSThe objective of this study was to investigate the effect of cerclage wire position and determine the number of wires necessary to prevent crack opening and stem subsidence following a proximal femoral fracture in cementless total hip arthroplasty. A cementless femoral stem one size larger than the templated size was inserted into each femur to initiate a proximal crack. A cerclage wire was wrapped around the fracture in one of two orientations: 1) parallel to the osteotomy (PO) and 2) normal to the fracture line (NF). The femur was compressed to a load of 890 N, 1780 N and 2670 N while crack opening and stem subsidence were measured. A second cerclage wire was placed parallel to NF wire and inferior to the lesser trochanter and a third wire was placed 1 cm distal and parallel to the second wire. The loading was repeated again. The mechanical evaluation of stem subsidence were verified by various computer simulations even using four wires. We have found that placement of the cerclage wires normal to the fracture line prevents stem subsidence and crack opening better than placement of the wires parallel to the osteotomy. Three cerclage wires, placed normal to the fracture line at three locations: 1) adjacent to the superior of the lesser trochanter, 2) adjacent to the inferior of the lesser trochanter and 3) 10 mm distal to the bottom of the lesser trochanter were necessary to achieve stability under higher loads.View full abstractDownload PDF (617K) -
Masaru Tateda, Kiyoto Shiga, Shigeru Saijo, Jyunkichi Yokoyama2000 Volume 192 Issue 1 Pages 49-59
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSThirty-nine previously untreated patients with squamous cell carcinoma of the oral tongue treated with curative intent in our hospital from 1993 through 1998 are reviewed. Of these patients, those in the early stage (stages I and II) constituted 64%. The over all 5-year survival rate of all the patients was 60%. The 5-year survival rate of the patients with early stage cancers was unsatisfactory (stage I: 73%; II: 56%). This was thought to be related to the absence of elective neck dissection and the administration of chemotherapy in the patients with early stage cancer. We concluded that elective neck dissection for levels I, II and III is the first choice of treatment strategy for patients with stage II cancer. Our data indicate that chemotherapy in patients with early stage cancer was not beneficial and might have increased the risk of late lymph node metastasis in the clinically N0 patients without neck dissection. There were 9 patients younger than 40 years of age and their survival rate at 5 years was 80%, which was better than that of the older patients. The treatment strategy for patients younger than 40 years of age was similar to that of older patients.View full abstractDownload PDF (576K) -
Ikuko Takahashi, Tsutomu Takahashi, Tamaki Abe, Wataru Watanabe, Goro ...2000 Volume 192 Issue 1 Pages 61-66
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSEnzyme activities of acid sphingomyelinase (ASM) were determined in various human cell-free body fluids, serum, cerebrospinal fluid, urine, salivary fluid, tear fluid, and synovial fluid, using assay buffers with or without Zn2+-cation. Although ASM activity was not detected in the cerebrospinal fluid, the other fluids demonstrated significant enzyme activities of ASM. All ASMs detected in the fluids were stimulated by the addition of Zn2+-cation, suggesting that those enzymes are secretory ASM derived from ASM gene. We suggest a possible enzymatic diagnosis of Niemann-Pick disease types A and B using those body fluids. Interestingly, salivary and tear fluids showed much higher activities of ASM than those of the other fluids. Because sphingolipids, especially sphingomyelin, are major constituents of a normal diet, especially, milk, eggs, and meat products, we suggest that ASM in the salivary gland may play an important role in the digestion of sphingomyelin in a normal diet.View full abstractDownload PDF (385K) -
Hiroko Kawata, Koichi Kuroda, Yoko Endo, Yoshinori Inoue, Ginji Endo2000 Volume 192 Issue 1 Pages 67-79
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSIn order to determine guanosine-5'-triphosphatase (GTPase) activity, we developed a simple, rapid and reliable method that utilizes capillary electrophoresis without radioisotope. Tubulin-GTPase was used for simple measurement of GTPase activity utilizing capillary electrophoresis. Tubulin, a component of microtubules, was incubated with guanosine-5'-triphosphate (GTP) in 100 mM 2-(N-morpholino) ethanesulfonic acid (MES) buffer (pH 6.5). Guanosine-5'-diphosphate (GDP) was determined as the hydrolyzed product of GTP. Guanosine-5'-monophosphate, GDP and GTP in the filtrate of the mixture were clearly separated using 10 mM MES buffer (pH 6.5) (migration time, 3.8, 5.5 and 7.2 minutes, respectively) with a fused-silica capillary column. The quantification of GDP was based on the peak area, which increased linearly with the concentration of GDP from 1 to 50 μM (r2=0.995). The peak area and migration time had good reproducibility; the intra-assay coefficient of variation (n=6) was 1.3% for peak area and 0.6% for migration time. As an application of this method, we examined the effect of dimethylarsinic acid, an effective antimitotic agent, on tubulin-GTPase. Dimethylarsinic acid inhibited tubulin-GTPase activity in a dose-dependent manner. The inhibition was not complete and the maximum decrease of the activity was about 50% at 200 μM dimethylarsinic acid. Thus, since this method is clean, simple and rapid, its application to the study of various GTPase proteins is expected to be useful.View full abstractDownload PDF (708K)
Case Reports
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Takashi Ohrui, Hidenori Takahashi, Satoru Ebihara, Toshifumi Matsui, K ...2000 Volume 192 Issue 1 Pages 81-86
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSThis report presents the cases of two patients with rapidly progressive hypoxemia associated with influenza A(H3N2) virus infection, who were diagnosed with influenza related acute pulmonary microthromboembolism by serum D-dimer, lung perfusion and ventilation scans and computed-tomography scan of the chest, and were successfully treated by anti-coagulant therapy. The present cases suggest that acute onset pulmonary microthromboembolism should be considered in some patients with sudden, unexplained dyspnea during an outbreak of influenza infection and prompt diagnosis is essential to save the patient from acute death associated with influenza.View full abstractDownload PDF (1268K) -
Kazuei Ogawa, Tsutomu Shichishima, Naoya Nakamura, Yukio Maruyama2000 Volume 192 Issue 1 Pages 87-98
Published: 2000
Released on J-STAGE: April 21, 2005
JOURNAL FREE ACCESSThe leukemic cells of a patient with hairy cell leukemia were treated in vitro with 2'-deoxycoformycin (dCF), an inhibitor of adenosine deaminase, and deoxyadenosine (dAdo). Following this treatment, viability of the hairy cells progressively declined, and DNA fragmentation was observed. When the patient was treated with 4 mg/m2 dCF intravenously, hairy cells in his peripheral blood rapidly decreased, and a large number of TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP- biotin nick end-labeling)-positive cells were detected in a bone marrow biopsy specimen. These findings indicate that dCF induced apoptosis of hairy cells both in vivo and in vitro. Furthermore, bcl-2 mRNA was down-regulated by dCF and dAdo in the hairy cells in vitro. Our results suggest the importance of bcl-2 mRNA regulation in apoptotic cell death mediated by dCF in hairy cell leukemia.View full abstractDownload PDF (2869K)
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