Journal of Nippon Medical School
Online ISSN : 1347-3409
Print ISSN : 1345-4676
ISSN-L : 1345-4676
Volume 66, Issue 1
Displaying 1-13 of 13 articles from this issue
  • [in Japanese], [in Japanese]
    1999 Volume 66 Issue 1 Pages 2-3
    Published: 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
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  • Kyoichi Mizuno, Shunta Sakai, Shinichi Ohkuni, Zhang Jing, Hirokazu Ha ...
    1999 Volume 66 Issue 1 Pages 7-14
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
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  • Hideyuki Iwaki, Atsuhiro Sakamoto, Shigeo Tanaka
    1999 Volume 66 Issue 1 Pages 15-20
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
    In clinical transplantation and cardiovascular surgery, cold preservation is usually used because it is a simple method. However, the established temperature is by no means exact. The aim of this study was to find the optimum storage temperature for preservation of the vasculature by observing the pharmacological endothelium and smooth muscle response. The thoracic aorta of 36 male Wister rats were studied in organ baths : as fresh control, after 24 hours, 48 hours and 72 hours of storage at 0.5°C, 4°C and 8°C in Krebs-Henseleit bicarbonate (KHB) solution. Acetylcholine (Ach) was used to elicit endothelium-dependent relaxation, and sodium nitroprusside (SNP) to elicit smooth muscle-dependent relaxation. The contractility caused by Phenylephrine (Ph) was influenced by time but before 48 hours it was not influenced by preservation temperature. Significant responsive deterioration by Ach and SNP was seen after 24 hours of storage at 0.5°C as compared with storage at 4°C and 8°C. The endothelium-dependent relaxing function and smooth muscle-dependent relaxing function were best preserved at 4°C and 8°C. These results indicate that precise temperature control is necessary for vessel preservation in clinical situations. (J Nippon Med Sch 1999 ; 66 : 15-20)
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  • Hitoshi Kadotani
    1999 Volume 66 Issue 1 Pages 21-27
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
    Patients with spinal cord lesions frequently show autonomic hyperreflexia. The mechanism of autonomic hyperreflexia has been thought to be an acute general autonomic overactivity in response to cutaneous or visceral stimuli, but it remains uncertain. Several kinds of experiments suggest that amplified spinal sympathetic reflexes in the decentralized cord are attributable to the denervation supersensitivity of denervated neurons, which is a well-known phenomenon in denervated muscle fibers. In the present study, changes in the supersensitivity of motoneurons after cordotomy were studied in the spinal cord of neonatal rats. Responses to bath-applied noradrenaline (NA) were recorded from a ventral root of the isolated spinal cord of 6-day-old rat. In normal spinal cord, NA induced depolarization in motoneurons dose-dependently. α1-antagonist prazosin (3μM) inhibited the depolarization induced by NA, and α2-antagonist rauwolscine (1μM) potentiated it. In one group of rats, cordotomy was performed 4 days after birth by complete transection of the spinal cord at vertebrate 8th-10th thoracic level, and NA response was examine two days later (when they were 6 days old). In cordotomized rats, NA-induced depolarization was increased with respect to both amplitude and duration. α1-as well as α2-antagonists inhibited the NA response in the spinalized rats. Especially, both antagonists shortened the duration of NA response in the spinalized rats. Especially, both antagonists shortened the duration of NA response as compared to normal level. It is concluded that the denervation supersensitivity to NA appears 2 days after cordotomy in the spinal motoneurons of neonatal rats and that the supersensitivity to NA is attributable to the upregulation of bot α1-andα2-adrenoceptors on the motoneurons, indicating that a new type of α2-adrenoceptor function appears. (J Nippon Med Sch 1999 ; 66 : 21-27)
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  • Hitoshi Yamauchi, Yosuke Ishii, Hiroya Omori, Yukiko Takakusaki, Ken-i ...
    1999 Volume 66 Issue 1 Pages 28-32
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
    Background ; Although the surgical results of the modified Fontan operation continues to improve, there are various advantages and disadvantages in terms of the post operative condition associated with the Fontan modifications. Late morbidity and mortality are mainly due to arrhythmias, thromboembolic complications, systemic venous hypertension and infective endocarditis. We reported our experience of the modified Fontan operation to determine an appropriate procedure for each patient. Methods and Results ; Seven patients (ranging from the age 1~14 years) underwent a modified Fontan operation including a lateral tunnel (n=1), extracardiac conduit (n=2) and autogenous atrial tunnel (n=4). There was one hospital death due to sepsis in which the patient underwent lateral tunnel procedure. The mean follow up of another six patients was 20 months (ranging from 1~39 months) and all patients were classified as NYHA class I, and remained in normal sinus rhythm without any thromboembolic complications. Conclusion ; When using the autogenous atrial tunnel, there are potential advantages ; it is not associated with thromboembolism or endocarditis and has growth potential. However, in high-risk patients with increased pulmonary vascular resistance, impaired ventricular function and pre-operative atrial arrhythmias, it appears reasonable to use an extracardiac conduit. (J Nippon Med Sch 1999 ; 66 : 28-32)
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  • Kenzo Oba, Masaaki Hirai, Yumiko Ajiro, Kyoji Okazaki, Shuzo Sato, Kei ...
    1999 Volume 66 Issue 1 Pages 33-36
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
    To examine the relationship between the concentrations of urinary NAG and age, we measured ratios of urinary N-acetyl-β-D-glucosaminidase (NAG) to urinary creatinine (NAG index) in 137 healthy subjects, aged from 19 to 88 years. The study is also designed to evaluate the relationship between urinary NAG and blood pressure. The subjects were divided into 7 subgroups, according to their age (<30, 30-39, 40-49, 50-59, 60-69, 70-79, 80 or more years). There was a positive correlation between NAG index and age (r=0.36 ; P<0.001). The regression equation relating NAG index (y) to age (x) was y=0.065x+0.97. The mean NAG indexes for the 7 subgroups divided by age were significantly different (P<0.01). There was a positive correlation between NAG index and systolic blood pressure (r=0.18 ; P<0.05), but was not between diastolic blood pressure and NAG index. In multiple regression analysis, age and BUN significantly correlated with NAG index (r=0.32 ; P<0.01, r=3.3 ; P=0.07, respectively), although there was no correlation between systolic blood pressure and NAG index. This cross-sectional study showed a clear elevation in NAG index with age. The rate of elevation was 0.65 per decade. Urinary excretion of NAG may be unrelated to blood pressure. (J Nippon Med Sch 1999 ; 66 : 33-36)
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  • Masayo Wada, Masahiko Onda, Akira Tokunaga, Teruo Kiyama, Toshiro Yosh ...
    1999 Volume 66 Issue 1 Pages 37-40
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
    Spontaneous gastrointestinal perforations in three patients with lymphoma were considered to be treatment-related conditions. All three were diagnosed as having malignant lymphoma by histological examination, and treated with chemotherapy and steroids. Four to 14 days after the start of chemotherapy, they complained of abdominal pain and plain rentogenograms revealed pneumoperitoneum. The interval between the onset of peritonitis and operation was almost 24h. Emergency operations were carried out ; one patient with a jejunal perforation underwent resection of the jejunum, another with a gastric perforation received a simple closure with omental patch, and the third with a gastric perforation underwent gastrectomy. Two patients recovered from the surgery, while the gastrectomy patient died due to sepsis. The favorable outcome of the surgical intervention is attributed to early diagnosis, prompt exploration, and selective operative procedures. We recommended a simple closure with omental patch for gastroduodenal perforation. Resection and primary anastomosis are possible only in the small bowel. (J Nippon Med Sch 1999 ; 66 : 37-40)
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  • Sadayuki Kurosaki, Hirokuni Otsuka, Mayumi Kunitomo, Mamoru Koyama, Ru ...
    1999 Volume 66 Issue 1 Pages 41-44
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
    Delayed-type hypersensitivity with granulomatous lesions to silk sutures is rather rate. Yet, braided silk sutures often act as a non-immunologic foreign-body and cause a granulomatous in-flammatory reaction years after surgery. We report here a case of recurrent granulomas with remarkable infiltration of eosinophils that may have resulted from an IgE-mediated hypersensitivity reaction to silk fibroin, a component of the braidid silk suture. Under normal circumstances exposure to fibroin is rather rare. Therefore, the present patient may have developed this reaction to the silk sutures used in a previous surgery. (J Nippon Med Sch 1999 ; 66 : 41-44)
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  • Shigeo Akira, Toshiyuki Takeshita, Tsutomu Araki
    1999 Volume 66 Issue 1 Pages 45-48
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
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  • Mahito Kimura
    1999 Volume 66 Issue 1 Pages 49-51
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
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  • Shin Kitamura
    1999 Volume 66 Issue 1 Pages 52-55
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
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  • Fumio Yamaguchi, Hiroshi Takahashi, Akira Teramoto
    1999 Volume 66 Issue 1 Pages 56-58
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
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  • [in Japanese]
    1999 Volume 66 Issue 1 Pages 79
    Published: February 15, 1999
    Released on J-STAGE: April 12, 2000
    JOURNAL FREE ACCESS
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