Evidence indicates that there are multiple sites in the hippocampal pyramidal cell dendrites which are capable of producing spikes. The multiple spikes generated there summate and form an excessive, prolonged depolarization known as the inactivation response (IR). Despite the fact that the IR consists of multiple components, the IR behaves in all-or-nothing fashion. This is explained as follows. Namely, in the dendrites there is a portion which is of low threshold for spike generation (the dendritic trigger zone) whereas the other portions in the dendrites are of high threshold. The spike of the dendritic trigger zone triggers spikes in the high threshold portions of the dendrites, resulting in the IR. Since the spike in the trigger zone is produced in all-or-nothing fashion, the IR thereby triggered is of necessity triggered in all-or-nothing fashion.
It is known that the spike originating in the somatic trigger zone conducts along the axon therewith carrying the informations arising within the cell onto the target cell. This is called the first carrier system for the sake of convenience. On the other hand, the IR is thought to produce a spike burst down in the axon while inactivating the soma spikes. A corollary from this is that once the IR is produced, the burst discharge thereby set up in the axon becomes the only means through which the informations are carried to the next cell. Consequently, the IR-triggered information carrying system is called the second carrier system, in contradistinction to the first carrier system mentioned above. Evidently then, the neuron with well developed dendrites has two independent systems for carrying informations to its target cell. It should be noted that although the second carrier system originates in the dendrites, not only the axo-dendritic input, but also the axo-somatic input can put this system into operation as evidenced by generation of the IR by current injection into the cell body. On the other hand, both inputs are also capable of activating the first carrier system, provided that the IR is not produced. In the second carrier system the informations are translated into the changes of the discharge pattern of the IR-triggered burst while in the first carrier system they are expressed as those of the discharge pattern of the single spike of the somatic trigger zone. A possibility has been pointed out that the parameters of the IR-triggered burst, i. e., the carrier of the second carrier system, are altered through a process leading to a plastic change.
The changes in the electrophysiological properties of the dendrites during seizure, including kindled seizure, have been discussed, especially from the viewpoint of plasticity.

抄録全体を表示

The changes in uterine muscle compliance are considered to reflect those of the uterine contraction. They were measured with the ultrasonic doppler method during the labor pains. The ultrasonic doppler method was compared with other methods of detecting the changes in the uterine contraction, i. e., the method of the internal tocometer, the external tocometer, the palpitation and the patient's compalints, and the following results were obtained.
1) The compliance measurement with the ultrasonic doppler method was first tested on the rubber of known consistence, and found to show excellent sensitivity.
2) In detecting the onset and the end of the uterine contraction, the ultrasonic doppler method was much more superior to other methods.
3) The duration of the uterine contraction measured with the ultrasonic doppler method was very similar to that measured with the internal tocometer method.
4) The cycles of the labor pains obtained with the ultrasonic doppler and the internal tocometer methods were very similar to each other.
5) From the above results, it may be concluded that the ultrasonic doppler method very accurately measures the uterine contraction and therefore applicable to clinical use.

抄録全体を表示

There are only a few reports in the literature, concerning the aging changes of the alimentary canal from the stomach to the colon. For that reason, the author has investigated the histopathological changes of the gastro-intestinal tract of the various age group to elucidate the cytological features which are encountered in aging process. Ninety six fresh autopsy cases with no primary alimentary tract diseases were investigated light microscopically (LM). Besides, materials of the biopsy cases were taken from duodenum and colon by fiberscope, and examined by LM as well as scanning and transmission electron microscopic (EM) studies. Furthermore, a semi-quantitative analysis of DNA in the nuclei of the colonic mucosal epithelium was performed. Moreover, alteration of the intestinal absorption in the rat intestine with aging has been investigated in virtue of the tracers such as fesin and horseradish peroxidase (HRP).
The results were as follows :
1) Atrophy and intestinal metaplasia of the gastric mucosa became much more evident as the aging proceeds. The quantitative determination of the thickeness ratio between the mucosa and muscular layer is performed, revealing the result that the relative decrease of the mucosal thickeness in aging process.
2) The duodenal mucosa revealed gradual morphological evidence for atrophic process with aging.
3) Atrophy of the mucosal and muscular layers of the small intestine and the colon in autopsy materials became evident with aging and also fibrosis of muscular layer increased parallel to aging. Furthermore, in biopsy materials of the colon, increase of granular cells at the bottom of the crypts was observed with aging.
4) Arteriosclerosis usually began over thirty years of age and were observed more commonly and remarkably with aging. Therefore, it was postulated that arteriosclerosis should be responsible for the mucosal atrophy per se.
5) The transmission EM study showed no noticeable change of the mucosal basement membrane of duodenum and colon with aging, except for increasing of collagen fibrils in adjacent areas. The scanning EM study revealed decreased wrinkling pattern of the mucosal villi which was seemed to correspond to mucosal atrophy as seen with the LM examination.
6) The semi-quantitative analysis of DNA in colonic biopsy materials revealed the tendency of decrease in volume upon aging. The capability of DNA synthesis declined with aging in the bottom epithelium of the colonic mucosal pit.
7) There was no obvious differences concerning the absorption of fesin and HRP between young and aged rats, except for suckling stage.

抄録全体を表示

Although each heart disease has its own characteristic configuration of cardiac silhouette in the chest X-ray film, its evaluation is made only empirically at present. The purpose of this study is to develop a quantitative method for diagnosis of cardiac silhouette. Eighty-six cases were employed for the study: 20 with mitral valvular disease, 13 with aortic valvular disease, 17 with atrial septal defect, 10 with ventricular septal defect, 8 with myocardial infarction and 18 healthy controls without any abnormalities in the circulatory system.
Chest X-ray films were taken in 6 projections with intervals of 30 in the standing position at the fixed phase of systole using ECG-trigger apparatus. Cardiac silhouettes were measured by AMDCOX (automatic measurement by densitometry-computer system of X-ray) developed in our depertment before.
The vertical distance from the intersection of sternum and the lower margin of the third rib to the intersection of the right cardiac border and diaphragm was divided evenly into 5 horizontal sections, and the horizontal width of the heart in each section was measured.
Examining the frequency distribution functions of these values or their combinations in each disease group, 14 parameters were selected as useful items. Using these items, discriminant functions for simultaneous differentiation of 6 disease groups were derived by means of “Theory of Quantification”.
According to this theory, the solution is given by 5 latent roots in case of differentiation of 6 disease groups. Namely, each individual case is expressed by a combination of 5 scores. In order to make the judgement easier, however, 3 graphs, each consisted of a pair of the scores, were used for practical differentiation.
The scores in each disease group showed a characteristic distribution on these graphs, indicating that the diseases can be differentiated by the boundary lines which were drawn to separate them. By use of these boundary lines, all cases of mitral valvular disease, ventricular septal defect and myocardial infarction were diagnosed correctly. Misdiagnosis was made only in each one case of aortic valvular disease, atrial septal defect and healthy controls. Thus, the high rate of correct diagnosis of 96.5% was obtained (83 out of 86 cases). Three misdiagnosed cases were plotted in the vicinity very close to the boundary lines. This means that the misdiagnosis could be avoided by careful judgement in such cases.
These results indicate the practical usefulness of the automatic and quantitative differentiation of the cardiac silhouettes in clinical medicine

抄録全体を表示

The cardiac surgery has made a remarkable progress in recent years. On the other hand, various types of arrhythmias following open heart surgery have become serious clinical problems. In the present study a series of the cases of complete right bundle branch block with left anterior hemiblock (CRBBB c LAH) following a radical operation for an ventricular septal defect (VSD) and tetralogy of Fallot (TF) was analyzed in terms of the function of the coducting system.
CRBBB coupled with LAH occured in 5 of 43 total cases (11.6%) following operation for VSD and TF. The percentage agrees with that reported by other authors. Measurement of the intervals of the cardiac cycle in electrocardiograms of the bundle of His (HBE) showed normal values except in 2 cases of VSD in which the H-V interval was prolonged to 55 msec. After right atrial pacing all conductions were found to retain 1 to 1 correspondence even at a maximum pacing rate of 240 per minute. The sinus node recovery time (SNRT) (460-1080 msec) corrective sinus node recovery time (CSRT) (-40 -355 msec), measured by the overdrive and suppression test, were both within the normal range. Measurements of the A-V node effective refractory period (AVN-ERP) and A-V node functional refractory period (AVN-FRP) showed normal values in all 4 cases.
During an observation period of twelve to thirty-four months, all patients convalesced without any evidence of complete heart block and Adams-Stocks attack, showing normal sinus rhythm. These results are in agreement with other data recently published.

抄録全体を表示

In an attempt to find the functional and morphological features of the renal glomerular mesangium, the histochemical localization of adenosine triphosphatase (ATPase) activity in the glomerular mesangial cells of the rat kidney was investigated by light microscopy and electron microscopy. Their relationship to the smooth muscle cells of the medial layer of the arterioles which include the juxtaglomerular apparatus was also investigated. Moreover, the correlative study of the histochemical property of the both cells in the developmental stage of the renal glomeruli was performed.
The Wachstein-Meisel's method was utilized to demonstrate its activity. The specificity of the histochemical reaction was further checked, light microscopically, by the alternative use of several substrates or activators for some of phosphatase activities, and by the addition of inhibiting agents in incubating media as the blocking tests.
The reaction product of ATPase activity was distributed in varying degrees of intensity in association with plasma membranes of various cells in the renal glomeruli, vessels and tubules, in the form of electron-dense aggregates of lead phosphate. In the glomerular mesangium and the media of the arterioles, the reaction product was intensively and uniformly observed on the membranes of the mesangial cells and the smooth muscle cells. The pattern of the enzymatic staining reactions in the mesangial cells was very similar to that in the arteriolar smooth muscle cells and the juxtaglomerular cells.
In the newborn rat kidney, the reaction product of ATPase activity increased with the progress of zonal differentiation of the nephron and vascular network, and also with the developing function and constitution of the glomerular mesangium and the media of the arterioles. In the development of the mesangium and its relation to the arteriolar smooth muscle cells, the each cells were regarded as having the identical cellular property on the histochemical localization of ATPase activity. Moreover, the pattern of this histochemical reaction in the interstitial mesenchymal cells around the S-shaped tubule was similar to that in the pericyte-like cells which had been regarded as the source of the mesangioplastic cells.
It is concluded that the glomerular mesangial cells and the arteriolar smooth muscle cells are identical in the nature and the property of the enzymatic histochemical reactions of the each cells.

抄録全体を表示

Unsuspected cardiovascular lesion or myocardial infarction was frequently envountered at the autopsy of the patient who had manifested cerebral symptoms. Okinaka et al. found that the majority of these cases showed myocardial and cerebral infarction but in some other cases no macroscopical findings were noticed in cerebrum. Nowadays “Cardiocerebral apoplexy” is applied to such a paticular case of myocardial infarction with cerebrovascular accident.
With regard to the concomitant association of the vascular lesion of brain and heart, the most interest has been focussed on the apoplectic attack and brain-heart interaction.
For clarifying the pathogenesis of this syndrome, it is mandatory to investigate cardiac lesions in cases of cerebrovascular diseases and also cerebral lesions in cases of cardiovascular diseases.
Incidentally, the collaborative investigation which has been performed in our laboratory revealed the following results. Namely, there was significant complication of myocardial infarction or marked myocardial fibrosis in 79% of cerebral infarction. There were marked arteriosclerotic changes in basilar nuclei of cerebrum in some cases of myocardial infarction.
This result suggests the morphological evidence for the existence of “Ischemic cardioencephalopathy”. And it also suggests the existence of multi-foci ischemic lesions which are wide spread in the various visceral organs.
This study is mainly concerned with the ischemic changes of kidneys, pancreas and adrenal of cerebrovascular diseases, especially cerebral infarction.
The results obtained were as follows. (
1) Renal ischemic changes such as renal infarction and subcortical micro-infarction were observed more frequently in cerebral infarction (CI) than in cerebral hemorrhage (CH). Sclerotic changes of arcuate artery was more marked and hyalinosis of afferent arteriole was more frequent in CI than in CH. (
2) There was nosignificant difference in the degree of pancreatic fibrosis between Cl and CH. But the sclerotic changes of inter-lobular artery were more pronounced and hyalinosis of arteriole was more frequent in CI than in CH. (
3) In adrenal, marked ischemic changes such as massive collapse of cells, fibrosis and infarction were only seen in Cl. Arteriolosclerosis was marked in both CI and CH. (
4) Twentyfive% of CI showed marked ischemic changes in kidneys, pancreas and heart. (
5) Four cases of cardiocerebral apoplexy revealed old and fresh myocardial and cerebral infarction. They also revealed moderate to marked ischemic changes of other organs. (
6) It is concluded that multi-foci ischemic changes involving the visceral organs may be present in some cases of Cl.

抄録全体を表示

Recently, D-penicillamine treatment has been provided to patients with rheumatoid arthritis frequently. This drug can definitely be considered as one of the most effective medications. However, this brings out various side-effects. This time, we experienced a case of myasthenia gravis induced by D-penicillamine treatment, and we hereby report on this specific case together with some discussion and literature studies. Several cases of myasthenia gravis associated with D-penicillamine treatment have been reported in European countries and in the United States, but we have not found any of the cases in Japan through our investigation.
The case : A 39-year-old woman with a 6-year history of rheumatoid arthritis had been treated in our clinic with a medication of 200 mg D-penicillamine per day. With the 20 weeks duration of the above dosage, the patient began to reveal symptoms such as dysarthria, dysphagia and ptosis. We immediately discontinued the medication of D-penicillamine. The patient was diagnosed as myasthenia gravis with a Tensilon test. We began to make a therapeutic approach with 10 mg of prednisolone and 120 mg of pyridostigmine per day, then the above symptoms were improved after four months.
The myasthenia gravis due to D-penicillamine treatment reported here may be quite rare, but should be considered as a warning indication to physicians that D-penicillamine should be administered with care and concern.

抄録全体を表示