Journal of Nippon Medical School
Online ISSN : 1884-0108
Print ISSN : 0048-0444
ISSN-L : 0048-0444
Volume 56, Issue 6
Displaying 1-13 of 13 articles from this issue
  • Hisashi Ohkuni
    1989Volume 56Issue 6 Pages 529-534
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
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  • Kyoko Ikakura
    1989Volume 56Issue 6 Pages 535-544
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
    To investigate the prognostic factors, 30 cases of hypertensive primary thalamic hemorrhages with a poor or fatal outcome were studied. The age of the patients ranged from 42 to 84 years (mean: 64.4). Their level of consciousness, ocular deviations and pupillary abnormalities were analyzed in relation to the estimated volume and the extension of the hematomas.
    The level of consciousness was classified according to neurological grading (NG) of Kanaya et al. Twelve cases (40.0%) were above NG 4a. In high-aged patients, NG 1 or 2 often indicated a poor prognosis. A downward deviation or gasing nose (also known as 'thalamic eyes') was found in 13 cases (43.3%). Pupillary abnormalities were seen in 26 cases, and bilateral miosis (14 cases) indicated a poor prognosis. The extension of the hematoma consisted of 'downward' (type D), 'lateral' (type L) and 'upward' (type U), and combinations there of. Types U and D were thought to portend a poor prognosis.
    The following factors were thought to indicate a poor prognosis: (1) uncontrollable high blood pressure, (2) upward extension of the hematoma associated with large ventricular cast, (3) downward ocular deviation, bilateral miosis and downward extension of the hematoma (the first two were considered as indication of the hypothalamus and the midbrain being affected), (4) advanced age.
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  • Pathogenesis of delayed traumatic intracerebral hematomas
    Takurou Okada
    1989Volume 56Issue 6 Pages 545-558
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
    Eighty three cases of traumatic intracerebra, hematomas (maximum diameter of at least 3 cm) were classified into the following two groups. Group-1 consisted of 34 cases in which intracerebral hematomas were confirmed in the initial CT scans on admission. Group-2 consisted of 49 cases in which intracerebral hematomas were found not in the initial CT scans on admission, but in the second or later CT scans. This is the so-called CT-diagnosed delayed traumatic intracerebral hematomas which have been widely reported in recent years with the increasing use of CT scans. These two groups were studied clinically and the following results were obtained.
    1) Traumatic intracerebral hematomas were apt to occur in middle-aged or elderly patients, and more delayed cases increased in patients of 60 or older.
    2) The times when the formation of traumatic intracerebral hematomas was judged as completed showed two peaks: within 6 hours after the trauma and 12 to 24 hours after the trauma.
    3) Excluding traumatic hemorrhages in the basal ganglia, there were many hematomas in the frontal lobes in the cases of coup injuries by anteroposterior force or contre-coup injuries by posteroanterior force and in the temporal lobes in the cases of contre-coup injuries by lateral force. Traumatic hemorrhages in the basal ganglia were seen in 10 cases, six of which were in Group-1. In all six of these cases, the intracerebral hematoma was confirmed within 6 hours after the trauma and the direction of the external force was unclear.
    Except for the findings described in 1) to 3), there were no differences in the basic pathogenesis and characteristics between the two groups. These results indicate that there is no essential difference in pathogenesis between CT-diagnosed delayed traumatic intracerebral hematomas and other intracerebral hematomas, as far as the present clinical studies are concerned.
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  • Yasunobu Sawazaki
    1989Volume 56Issue 6 Pages 559-564
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
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    This study investigated the presence of arachidonic acid metabolites, (leukotriene B4, leukotriene C4 and prostaglandin E2) in the serum, synovial fluid and synovium of rheumatoid arthritis patients (RA). We obtained the serum, synovial fluid and synovium from 16 female patients with RA during knee operations. Leukotriene B4 (LTB4), leukotriene C4 (LTC4) and prostaglandin E2 (PGE2) were detected by RIA analysis.
    In the patients administered steroids, a positive correlation was found between the concentrations of LTB4 and PGE2 in the synovium. In the patients not administered steroids, significant correlations were found between the concentrations of LTB4 in the synovium and serum, and also between the concentrations of LTB4 and LTC, in the synovium.
    The levels of immunoglobulins and LTB4 in the serum were determined and a significant correlation was found between the content of IgG and the concentration of LTB4.
    In the serum, the concentration of LTB4 was elevated in RA patients relative to the control normal subjects, and the difference was statistically significant. In conclusion, these data suggest that LTB4 in the serum reflects the concentration of LTB4 in the synovium.
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  • Mitsuo Motoyama, Hirohei Takayama, Akinori Aoyama, Akira Minagawa
    1989Volume 56Issue 6 Pages 565-578
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
    We attempted to clarify the effects of aging and the difference between heavy and mild exercise training on the fat and amino acid (AA) systems of streptozotocin diabetic Sprague-Dawley rats in vivo. We exercised two groups of rats, both composed of juvenile and aged rats. The first group, however, consisted of diabetic rats only, the second of normal rats only. Both groups underwent mild training, 20 cm/s, or heavy training, 33 cm/s, for an hour a day, five times a week for four weeks. We looked for fat and amino acids in the serum, liver, red skeletal muscles and heart muscles at the pre- and post-training stages.
    The results were as follows:
    Although we observed decreased triglyceride (TG) levels in the serum, liver and intraskeletal muscles in the normal control gorup, similar decreases were also observed in the diabetic group undergoing insulin treatment with mild exercise training. On the other hand, we observed a clear increase in the rats subjected to heavy exercise training. This increase was particularly significant in the aged rats. There was, however, no significant change in the TG levels in the intraheart muscles of either the juvenile or aged rats, including the diabetic ones.
    Exercise training in the normal control group produced decreases in total AA, glycogenic AA, branched chain AA and ketogenic AA. Although there was no significant decrease in the TG levels in the serum, we could see clear signs of a decrease in the liver and the intraskeletal muscles. By contrast, the more the rats undergoing insulin treatment for diabetes were exercised, the greater the increase in the amount of AA in the livers and intraskeletal muscles. These changes were especially significant in the aged group. Consistent with previous reports, the diabetic groups produced different results for fat and AA in proportion to the intensity of exercise training and age of the rats. We also demonstrated that the differences were very small in the serum, but significant in the organs, livers and skeletal muscles.
    From the above findings, we have concluded that exercise training should play a major role in the treatment of diabetes in consideration not only of serum, but also transitions of the whole body's metabolic phases, including the intraorganic systems.
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  • Yoichiro Yamanaka, Masahiko Onda, Eiji Uchida, Shigeki Yokomuro, Tomoh ...
    1989Volume 56Issue 6 Pages 579-583
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
    Localization of Na+, K+-ATPase in the human pancreas was investigated immunohistochemically using rabbit antisera against Na+, K+-ATPase of the human kidney. The reaction product existed only on the luminal surfaces of both centroacinar and ductal cells in normal pancreatic tissue, whereas in chronic pancreatitis the localization of Na+, K+-ATPase was found frequently on the luminal surfaces of both centroacinar and ductal cells, and on the basolateral surfaces of some ductal cells. However, in acinar cells, the distribution of Na+, K+-ATPase was not detected in either the normal pancreas or chronic pancreatitis. In pancreatic carcinoma tissues, Na+, K+-ATPase existed very rarely in malignant cells. These results indicate that Na+, K+-ATPase is immunohistochemically localized on the membranes of centroacinar and ductal cells of the human pancreas, and that the antigenicity of Na+, K+-ATPase in pancreatic carcinoma cells differs from that in normal cells.
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  • Kiyohide Hirata
    1989Volume 56Issue 6 Pages 584-591
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
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    There have been some metrical studies on the aorta of human adults. However, little work has been done on Japanese fetuses. This study was carried out to investigate such arterial changes during the fetal age period of 6-8 months as (1) lengths of the aortic arch, thoracic aorta and abdominal aorta, (2) relative positions on the aorta where main aortic branches arise, and (3) diameters of the main aortic branches.
    The results were as follows:
    1) The total length of the aorta increased with fetal age. Growth rates of the aortic subdivisions were different from one another. During the 6-7 month period, proportions of the aortic arch and the abdominal aorta to the whole aorta increased. On the other hand, the proportion of the thoracic aorta decreased during this period. During the 7-8 month period, the proportions of each subdivision were unchanged.
    2) Diameters of the main aortic branches and distances between these branches and the brachiocephalic artery were measured. During the 6-7 month period, the relative positions of arteries arising from the aortic arch moved toward the heart along the aorta, while the celiac artery, superior mesenteric artery and renal artery moved downward. The relative positions of the ductus arteriosus and the inferior mesenteric artery remained unchanged during the period. No change was seen in the relative positions during the 7-8 month period.
    3) Distances between the arising points of the left and right intercostal arteries were measured on the dorsal surface of the thoracic aorta. The distance was wider in the upper segment of the aorta than in the lower segments. A good correlation between the distance and fetal age (6-8 months) was recognized only in the upper segments.
    4) Distances between arising points of adjacent upper and lower intercostal arteries were measured on the dorsal surface of the aorta. The distance between the arising points of the 9th and 10th intercostal arteries was the largest in both the left and right sides. In general, the distance in the upper segments was larger than in the lower segments.
    5) The diameter of the common iliac artery, which is the terminal branch of the abdominal aorta, increased more rapidly than other main arteries.
    6) The 3rd and 4th intercostal arteries were most frequently seen to arise from the thoracic aorta as a common trunk. Formation of a common trunk was less frequent in lower intercostal arteries.
    7) The data obtained in the present study were discussed in comparison with those in adults.
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  • Kenichiro Katsura
    1989Volume 56Issue 6 Pages 592-601
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
    Human plasma leukotriene C4 (LTC4) levels of cerebral infarcted patients showed a significant increase and plasma vitamin A (VA) levels showed a significant decrease compared to the normal plasma obtained from age-matched control. Therefore, the effect of VA on leukotriene (LT) levels and the progress of cerebral edema were investigated in VA deficient Wistar rat brains. Incomplete global cerebral ischemia was induced by occluding the bilateral common carotid arteries (BLCO) with clips. Wistar rats were made VA deficient by feeding them a vitamin A deficient diet for 5 weeks on a specific pathogen free status. After 3 hours of BLCO the blood was reperfused by removing the clips. After each period of reperfusion, the rat brain was fixed by freezing in situ and used for assaying leukotrienes, vitamin A, and water content.
    Slow reacting substance of anaphylaxis (LTC4+LTD4+LTE4) levels showed an increase at the end of BLCO in the VA deficient group and the high levels persisted for 30 min and then decreased to the control level. Brain water contents were elevated significantly at the 30 min phase of reperfusion. With VA administration, the water contents tended to be lower than in the VA deficient group at any phase. Histologically, after ischemia and reperfusion, evans blue extravasation and marked spongioid formations around small vessels were observed in the VA deficient rats only.
    These facts indicate that VA functions to stabilize cell membranes and suppress ischemic cerebral damage.
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  • Yoshimune Mokode
    1989Volume 56Issue 6 Pages 602-611
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
    Studies of pulmonary arteriography have a long history in the diagnosis of lung tumors (Steinberg and Robb, 1938). The main purpose of these studies was mostly the determination of the resectability of neoplasms. So that the role of pulmonary arteriography on the diagnosis of peripheral lung tumors has yet been obscure. Neither conventional nor selective pulmonary arteriography can clearly visualize vascular structures of mass lesions in the peripheral lung fields, because of overlaid other segmental arteries, dilution of the contrast medium and blood flow shift.
    In the present study, direct catheterizations to the segmental branches of peripheral lung field mass lesions were performed on 62 cases, in order to visualize and investigate more detailed vascular structures of them. Twenty nine cases were of primary lung cancer; 14 of metastatic and 19 of inflammatory mass.
    By means of the superselective pulmonary arteriography, vascular wall irregularities and tumor stain were frequently observed in the cases of malignancies. Either occlusion of minute branches (1 mmz) or encasement of pulmonary arterial branches (1 mm<) was seen more frequently in the cases of primary lung cancers (86%) than in the cases of metastatic lung cancers (64%). Tumor stain was also observed both in the cases of primary lung cancers (55%) and metastatic lung cancers (64%).
    In the cases of primary lung cancers, tendency for visualization of vascular wall irregularities and tumor stain seemed to depend upon rather their histological types and differentiation grades than the size of the mass. Encasement or obstruction of the arterial branches (1 mm<) was seen more frequently in the cases of poorly differentiated adenocarcinoma, moderately differentiated squamous cell carcinoma and anaplastic carcinoma than in the cases of other histologic types. On the other hand, tumor stain was observed more frequently in the cases of moderately differentiated adenocarcinoma and anaplastic carcinoma than in the cases of other histologic types.
    Obstruction of arterial branches (1 mm<) was seen also in a few cases of the inflammatory masses, but that of inflammatory masses was usually distinguished from that of malignant masses by their characteristic surrounding vascular natures such as central vascular convergency, widespread simple narrowing of arterial branches and diminution or lack of ramification of minute branches. Tumor stain was not observed in the cases of the inflammatory masses.
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  • Junichi Ninomiya, Shigeo Tanaka, Tasuku Shoji, Yukihiko Nose
    1989Volume 56Issue 6 Pages 612-616
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
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  • Toshiaki Ando, Masahiko Onda, Akira Tokunaga, Takashi Mizutani, Teruo ...
    1989Volume 56Issue 6 Pages 617-621
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
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  • Association with immunotherapy and carcinoembryonic antigen
    Sachira, Masahiko Onda, Akira Tokunaga, Teruo Kiyama
    1989Volume 56Issue 6 Pages 622-624
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
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  • 1989Volume 56Issue 6 Pages 625-692
    Published: December 15, 1989
    Released on J-STAGE: July 10, 2009
    JOURNAL FREE ACCESS
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