岡山医学会雑誌
Online ISSN : 1882-4528
Print ISSN : 0030-1558
105 巻, 5-6 号
選択された号の論文の25件中1~25を表示しています
  • 東 良平
    1993 年 105 巻 5-6 号 p. 399-408
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    A nutritional and metabolic assessment of a cardiopulmonary bypass technique without donor blood was made in 23 patients undergoing open heart surgery (non-donor blood group). For comparison, 14 patients receiving cardiopulmonary bypass with donor blood prime (donor blood group) were also evaluated. 1)Serum transferrin level showed significantly more rapid recovery in the non-donor blood group compared to the donor blood group on the 7th post operative day. 2)Total protein, serum albumin, arm muscle circumference, creatinine-height-index and triceps skin fold showed no significant differences between the two groups. 3)Total lymphocyte count as an indicator of immune status showed a significant increase in the non-donor blood group on the 3rd post operative day. 4)The recovery from the postoperative hypermetabolic state was more smoothly achieved in the non-donor blood group than in the donor blood group. In conclusion, the cardiopulmonary bypass technique without donor blood is a safe and effective means of open heart surgery, not only saving blood but also preventing undue, infectious and/or hypersensitive diseases.
  • 金藤 悟
    1993 年 105 巻 5-6 号 p. 409-417
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Forty patients were subjected to multi - stage exercise tolerance tests using a bicycle ergometer prior to thoracotomy. During the test, expiratory gases were analyzed, and the arterial blood gas level and lactic acid level were studied. Postoperative complications were found in 10 of 40 cases (25%). Significant differences between patients with and patients without postoperative complications were recognized in VO2max, VCO2max and PaO2max.
    Patients with a VO2max value less than 1100 ml/min after the exercise test with a bicycle ergometer had a high risk of developing postoperative complications.
    Twelve postthoracotomy patients underwent the same test.
    All of their VO2max values were significantly lower than the corresponding preoperative values.
  • 鈴鹿 伊智雄
    1993 年 105 巻 5-6 号 p. 419-426
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    To clarify the relationship between the increase in subcutaneous tissue perfusion rate (TPR) upon inhalation of radon water and the vasoactive effects of radon, rabbits inhaled nebulized water containing 14, 000-18, 000Bq/l radon (radon group) taken from Ikeda Mineral Spring, Shimane Pref., Japan. Control rabbits inhaled radon water from the same springs which had been kept for over 10 radon half-life periods. TPR was evaluated 15 minutes after the beginning of inhalation by mass spectrometry.
    After inhalation for 90 minutes, plasma and adrenal glands were removed, and levels of adrenaline and noradrenaline were analyzed by high- performance liquid chromatography (THI method).
    Each group was divided into 4 subgroups according to intravenously injected medication as follows: 1) no medication (without adrenergic blocker), 2) phentolamine (α-blocker), 0.05mg/kg/min, 3) propranolol (non-selective β-blocker), 1mg/kg, and 4) atenolol (selective β1- blocker), 6mg/kg.
    In the radon group, plasma adrenaline and noradrenaline levels were significantly higher (p<0.01, p<0.05), and adrenal adrenaline and noradrenaline levels were significantly lower (p<0.01, p<0.01) than those in the control group.
    In the no medication and phentolamine subgroups, TPRs in the radon group were significantly higher than those in the control group (p<0.01, p<0.01). In the propranolol and atenolol subgroups, no significant change of TPR was found.
    It is suggested that catecholamines are secreted from the adrenal glands upon inhalation of radon water and that the β1-action of catecholamines contributes to the increase in tissue perfusion.
  • 第1編 低形成型骨髄造血異常症(Myelodysplasia with Hypoplastic Marrow)の検討
    仲田 浩之
    1993 年 105 巻 5-6 号 p. 427-436
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    To evaluate characteristics of myelodysplasia with hypoplastic marrow (MDH), clinical and hematological findings in 7 patients with MDH (group A) were compared with those of 23 patients diagnosed with myelodysplastic syndromes (MDS), 13 RAEB and 10 RAEB-T, according to French-American-British co-operative roup classification (group B). Cytopenia and morphological changes in 2 or 3 blood cell lines, corresponding to hematological characteristics of MDS, were observed in all patients in group A.
    Age distributions and gender ratios did not differ between groups A and B. As the initial symptom, anemia was recognized with a high incidence in both groups. Organomegaly such as hepatomegaly and splenomegaly were observed with nearly equal incidence in groups A and B. The grades of anemia, leukocytopenia and thrombocytopenia were nearly equal in groups A and B. The percentage of myeloblasts in peripheral blood was higher in group B than that in group A (3.4% versus 0.6%). However, in bone marrow, it was lower in group B than that in group A (11.3% versus 16.5%). The percentage of erythroblasts in bone marrow was lower in group A than group B (17.7% versus 26.6%). Two of 3 patients in group A and 7 of 18 patients in group B showed abnormal karyotypes. The progress from initial symptoms to definite diagnosis ranged from 0.7 months to 38.4 months (mean±SD: 10.1±13.0 months) in group A, and from 0.8 months to 83.3 months (mean±SD: 10.0±18.1 months) in group B, respectively. Four of 7 patinets (57%) in group A developed overt leukemia (1 case of hypoplastic leukemia, 2 cases of M2, 1 case of M5b) 1.314.3 months after diagnosis of MDH (mean±SD: 8.1±6.5 months), and 9 of 23 patients (39%) in group B also developed overt leukemia (6 cases of M2, 3 cases of M4) 0.514.5 months after diagnosis of MDS (mean±SD: 3.8±4.2 months). The median survival time (MST) from the initial symptoms tended to be longer in group A than that in group B (24.2 months verus 18.7 months). The MST from definite diagnosis also tended to be longer in group A than that in group B (17.4 months versus 12.1 months).
    These results suggest that MDH can be included into the clinical entity of MDS in respect to dysmyelopoietic disorders preceeding the onset of acute leukemia.
  • 第2編 非定型的白血病の治療に関する検討:4N-behenoyl-1-β-D-arabinofuranosyl-cytosine (BHAC)少量療法の臨床効果
    仲田 浩之
    1993 年 105 巻 5-6 号 p. 437-445
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Therapeutic effects of low-dose 4N-Behenoyl-β-D-Arabinofuranosylcytosine (BHAC) on 52 patients with hypoplastic leukemia were analyzed to establish the optimal clinical management of hypoplastic leukemia.
    Among 8 patients treated with a low-dose 4N-Behenoyl-β-D-Arabinofuranosyl cytosine (LD-BHAC) regimen, in which 50mg BHAC was administered daily intravenously by one-hour drip infusion for 14 days, 4 patients obtained complete remission (CR) and 2 patients obtained partial remission (PR). The response rate (CR+PR) was 75%. The responders were all over 65 years old. Although hematological toxicities and adverse effects on the digestive system such as anorexia and nausea were observed, they were all controllable by conventional treatments. The serum concentrations of ara-C were measured in 4 patients. Serum ara-C reached the peak concentration, 3.62-18.9ng/ml (mean: 11.74ng/ml), at the cessation of BHAC infusion, and a serum ara-C level of 2.75-4.89ng/ml (mean: 3.54ng/ml) was still present 6 hours after the cessation of infusion. Among 44 patients hospitalized before 1984, 27 patients were treated with blood transfusion and/or single antileukemic agent and 17 patients received combination chemotherapeutic regimens. Only 8 of 44 patients attained CR. The responders were all below 65 years old, and except for one patient, received combination chemotherapy.
    These results suggest that LD-BHAC therapy is useful in the clinical management of hypoplastic leukemia as a remission induction chemotherapy.
  • 佐藤 和良
    1993 年 105 巻 5-6 号 p. 447-454
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Free radicals, superoxide dismutase activity and lipid peroxides in the gingiva of Dental University (ODU) plaque-susceptible (Sus) rats were estimated at the ages of 1, 2, 3, 4, 5, 7 and 8 months, and were compared with those of control Wistar-kyoto rats.
    Low levels of hydroxy1 radicals were noted in the anterior and posterior gingiva of ODU Sus rats at 2 and 5 months, but significantly increased in the anterior gingiva at 4 and 7 months and in the anterior and posterior gingiva at 7 and 8 months, compared to those of control rats.
    Levels of carbon centered radicals were significantly higher in the anterior gingiva at 2 months and in both the anterior and posterior gingiva at 3 months.
    Superoxide dismutase activities were accelerated significantly at 2, 4 and 5 months, and then were reduced at 8 months in the anterior gingiva. Otherwise, they were at low levels in the posterior gingiva at 1 and 2 months, were accelerated at 3 and 4 months, and reduced again at 7 and 8 months.
    Thiobarbituric acid reactive substances decreased transitorily at 7 months in both the anterior and posterior.
    These experimental results suggest that free radicals may be related to the pathogenesis and development of gingivitis in plaque susceptible ODU Sus rats.
  • 武田 勝行
    1993 年 105 巻 5-6 号 p. 455-464
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    To clarify the initiation of late asthmatic response (LAR), the localization and fate of inhaled antigens were studied using an animal model of LAR. Guinea pigs were sensitized by ascaris suum and aluminum gel. Radioiodinated ascaris suum and ovalbumin as control were subsequently injected into the trachea of the guinea pig to determine the radioactivity of bronchoalveolar lavage (BAL) cells and fluid (BALF) components before and after LAR. The localization of antigens was also examined by autoradiography of BAL cells and lung tissue sections.
    The radioactivity of radioiodinated ascaris in BAL cells and lung tissue increased during LAR with increases in macrophages and neutrophils, although in non-responding animals inhaled antigens gradually disappeared from the airway. The radioactivity of radioiodinated ovalbumin gradually decreased regardless of LAR. Autoradiographic study showed that the inhaled antigens were located in the cytoplasm of alveolar macrophages in BALF and lung tissue.
    These data indicate that inhaled antigens may accumulate and migrate with numerous inflammatory cells such as macrophages and neutrophils in late phase bronchial response.
  • 飛岡 徹
    1993 年 105 巻 5-6 号 p. 465-473
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    The production of interleukin-1 (IL-1) in alveolar macrophages (AMs) was studied in 25 patients with sarcoidosis to investigate the role of immune mechanisms in this disease. The radioimmunoassay (RIA) method was compared with the bioassay method for detecting IL-1 in the supernatants of AM cultures. The level of IL-1β measured by RIA was closely correlated with the IL-1 activity measured by bioassay (r=0.88, p<0.01). The amount of IL-1β in the supernatant of AM cultures from sarcoidosis patients was compared with those from control subjects. No significant IL-1β activity was detected in the culture supernatants of unstimulated AMs from either group of subjects. However, the production of IL-1β by AMs stimulated with Propionibacterium acnes (P. acnes) was significantly higher in patients with sarcoidosis than in controls (p<0.05). Lipopolysaccharide (LPS) induced increased IL-1β production by AMs from both sarcoidosis patients and controls compared to unstimulated or P. acnesstimulated AMs, but the mean IL-1β level for sarcoidosis AMs did not differ from that for control AMs. There was no difference in the IL-1β production of peripheral blood monocytes between sarcoidosis patients and controls.
    These data suggest that AMs are activated in sarcoidosis and may modulate alveolar lymphocyte functions to play a critical role in the pathogenesis of the disease.
  • 小野田 裕士
    1993 年 105 巻 5-6 号 p. 475-487
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    To evaluate the biological malignancy of differentiated thyroid cancer, we determined the nuclear DNA content in thyroid tumors by flow cytometry using paraffin-enbedded materials. The subjects were 80 patients with thyroid tumors. The thyroid tumors were follicular adenoma in 11 cases and thyroid cancer in 69 cases. Of the 69 cases of thyroid cancer, 42 were histologically classified as papillary carcinoma, 18 as follicular carcinoma, 3 as medullary carcinoma and 6 as anaplastic carcinoma. DNA ploidy pattern and the percentage of proliferating phase cells were analyzed in relation to the prognosis and the following clinicopathological findings: age, gender, histological type, tumor size (t), extrathyroidal invasion (Ex), lymph node metastases (n) and distant metastases (M). DNA ploidy pattern correlated with histological type (p<0.005), but did not correlate with other clinicopathological findings. The percentage of proliferating phase cells correlated with age (p<0.01) and the histological type (p<0.05), but did not correlate with other clinicopathological findings. The percentage of proliferating phase cells correlated with age (p<0.01) and the histological type (p<0.05), but did not correlate with other clinicopathological findings. The cumulative survival rate (Kaplan- Meier) of differentiated carcinomas was worse in the aneuploid group than in the diploid group (p<0.0001). The percentage of proliferating phase cells increased as the prognosis deteriorated. The results suggest that flow cytometric DNA analysis may be useful to evaluate biological malignancy of thyroid tumors.
  • 竹内 龍三
    1993 年 105 巻 5-6 号 p. 489-498
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Enhancement in thyroid ultrasonography was investigated with thyroid lymphography by injection of Lipiodol into thyroid nodules in 50 patients. On plain thyroid ultrasonography (PU), the echo levels of normal and tumorous portions of the thyroid glands were evaluated. Then, the echo level ratios (P-N/T) were calculated. Moreover, by the same method, the echo level ratios between normal and tumorous portions of the thyroid glands were calculated 6 hours after Lipiodol injection (E-N/T), when the greatest enhancement was anticipated.
    The mean value of P-N/T was 1.305, and that of E-N/T was 1.474. The echo level ratio was significantly elevated in the enhancement method (p<0.0014). We concluded that the enhancement is obtained with Lipiodol injection into the normal portion of the thyroid glands, regardless of whether the tumor is benign or malignant and with or without cystic degeneration. This method is useful in promoting quality and location diagnosis of thyroid nodules.
    N: echo level value in the normal portion of thyroid gland
    T: echo level value in the tumorous portion of thyroid gland
    N/T: echo level ratio
  • 心プールシンチグラフィーによる検討
    岡田 富朗
    1993 年 105 巻 5-6 号 p. 499-512
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Left ventricular (LV) diastolic functions in 23 patients with aortic regurgitation (AR) and 22 patients with mitral regurgitation (MR) were evaluated by gated pool scintigraphy. LV myocardial biopsy was performed during open heart surgery, and LV myocardial ultrastructural chasges were evaluated by electron microscope. Correlation between LV diastolic function and myocardial ultrastructural change was examined. It was suggested that preoperative LV diastolic dysfunction occurred earlier than LV systolic dysfunction in patients with AR and MR. LV early diastolic dysfunction was especially significant in patients with AR. LV systolic function was significantly improved postoperatively compared with LV diastolic function in patients with AR and MR. It was suggested that LV interstitial fibrosis caused LV diastolic dysfunction in patients with AR and MR, and insufficiency of myocardial thickening as compensation in patients with MR. It was presumed that LV diastolic dysfunction was irreversible in patients with AR and MR in the distant postoperative period due to persistence of the preoperative myocardial ultrastructural change, e.g, interstitial fibrosis. these LV diastolic indices measured by gated pool scintigraphy were useful in predicting LV ultrastructual changes and postoperative LV dysfunction in patients with LV volume-overloaded valvular heart disease.
  • 荒木 一博
    1993 年 105 巻 5-6 号 p. 513-526
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    To elucidate direct ventricular interaction, equilibrium radionuclide ventriculography was performed on 18 cases of aortic regurgitation (AR) and 31 cases of mitral stenosis (MS) before and after open heart surgery.
    Patients with AR were divided into two groups by preoperative left ventricular volume: the normovolumic left ventricle (n-LV) group and the dilated left ventricle (d-LV) group. Patients with MS were divided into two groups by preoperative right ventricular volume: the normovolumic right ventricle (n-RV) group and the dilated right ventricle (d-RV) group.
    In patients with AR, preoperative right ventricular systolic function in the d-LV group was significantly impaired compared with that in the n-LV group. Postoperative right ventricular systolic function in the d-LV group improved to show no significant difference compared to that in the n-LV gruop because surgery alleviated the left ventricular dilatation.
    In patients with MS, preoperative left ventricular systolic and diastolic functions in the d-RV group were significantly impaired compared with that of n-RV group. In d-RV group, postoperative left ventricular systolic and diastolic functions were significantly improved when right ventricular dilatation could be relieved postoperatively.
    In the present study, the existence of direct ventricular interaction influenced by the volume-overloaded ventricle was clarified.
  • 槌田 昌平
    1993 年 105 巻 5-6 号 p. 527-541
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Regional cerebral blood flow (rCBF) was measured with xenon-enhanced CT (Xe-CT) in 21 cases of intracranial tumors (13 meningiomas, 5 gliomas, 3 metastatic brain tumors). Peritumoral edema was graded as mild, moderate or severe based on the extent of edema on CT and MRI. According to intratumoral blood flow distribution patterns, three patterns were classified as central type with relatively high blood flow at the center of the tumor, homogeneous type with an almost homogeneous blood flow distribution, and marginal type with relatively high blood flow at the periphery of the tumor. High grade astrocytoma and metastatic brain tumor showed marginal type blood flow and moderate or severe edema except in one case. Five meningiomas with severe peritumoral edema revealed marginal type blood flow and four with mild peritumoral edema showed central type blood flow, except for one cace. No correlation was found between the extent of peritumoral edema and histological subtype, tumor size, location, duration of clinical history, vascularization on angiogram, and mean blood flow in the tumor. These results suggest that blood flow distribution patterns within the tumor may affect the extension of peritumoral edema.
    Pre-and postoperative rCBFs were evaluated with Xe-CT and IMP-SPECT in 7 cases. mean rCBF of peritumoral edema was 6.2ml/100g/min preoperatively, and discrepancy between rCBF on Xe-CT and that on IMP-SPECT was shown in the remote cortical region ipsilateral to the tumor. Postoperative rCBF revealed an improved blood flow in both adjacent and remote areas, suggesting that the decreased blood flow associated with brain tumors might be relieved after surgery.
  • 山田 琢
    1993 年 105 巻 5-6 号 p. 543-558
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    We reproduced an in vitro model of staphylococcal scalded skin syndrome or bullous impetigo in human skin explants in culture, using partially purified staphylococcal exfoliative toxin A (ETA). ETA affects epidermal antigens such as keratins, involucrins, epidermal growth factor, epidermal growth factor receptor, HLA-DR, ICAM-1 and TNF-α were observed using the appropriate monoclonal antibodies. However, expressions of these antigens on cultured skin explants were not influenced by treatment with ETA compared to the controls without ETA treatment. 160kD desmoglein I is known to have an important role in attaching epidemal cells and is the target antigen of pemphigus foliaceus (PF) antibody. We examined the effect of ETA on the binding of PF antibody to 160kD desmoglein I by indirect immunofluorescence, using a PE patient's serum. The intensity of the fluorescence of the bound antibody was clearly reduced by ETA pretreatment. The binding of pemphigus vulgaris antibody did not seem to be influenced by ETA pretreatment. ETA did not have any effect on the binding of pemphigoid antibody to the basement membrane zone.
    These results suggest that the binding site of ETA is closely related to PF antigen (desmoglein I) and that the epidermolysis by ETA occurs without involvement of cellular or humoral factors in the host.
  • 光延 文裕, 貴谷 光, 御舩 尚志, 梶本 和宏, 杉本 啓介, 横田 聡, 平松 順一, 瓦家 正志, 谷崎 勝朗
    1993 年 105 巻 5-6 号 p. 559-562
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    The commercially available radioallergosorbent test (RAST) is still widely used as a good diagnostic tool for diagnosis of allergic diseases. Recently, a new in vitro test (Pharmacia CAP System and MAST Immmunosystems MAST system) was proposed to measure IgE antibodies in a quantitive manner. The MAST System is based on cellulose fiber in a sort of pipette. The carrier can bind many kinds of allergens in the CNBr (cyanogen bromide) activated form, compared to the RAST paper disc. In this study, we exanimed serum levels of specific IgE antibodies to food allergens and inhalant allergens in forty bronchial asthma patients using the MAST System.
    Higher positivities of specific IgE antibodies were found in inhaled allergens than in food allergens. Although high positivities of specific IgE antibodies against food allergens did not correlate to patient age or age at onset, positive reaction to inhaled allergens in the MAST System was frequently observed in patients under the age of 40 or in those under age 30 at onset. The MAST System, which can measure specific IgE antibodies against sixteen different allergens with a single sample, is suggested to identify a larger number of atopic patients than RAST.
  • 御舩 尚志, 瓦家 正志, 平松 順一, 横田 聡, 杉本 啓介, 梶本 和宏, 光延 文裕, 貴谷 光, 谷崎 勝朗
    1993 年 105 巻 5-6 号 p. 563-568
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    To evaluate the pathogenetic role of leukotrienes in bronchial asthma, the release of leukotrienes from bronchoalveolar lavage cells stimulated by calcium ionophore A23187 was measured by high performance liquid chromatography.
    The release of leukotrienes from bronchoalveolar lavage cells in asthmatics with simple bronchoconstriction did not increase compared to those with other types of asthma.
    The number of BAL eosinophils in asthmatics with bronchoconstriction and hypersecretion increased. The release of leukotriene C4 from BAL cells in asthmatics with type Ib (hypersecrection type) was higher than that in those with type Ia (bronchoconstriction type). The release of leukotriene B4 was also signicantly higher in asthmatics with type Ib than that in those with type II (bronchiolar obstruction type).
    The number of BAL neutrophils increased in asthmatics with bronchiolar obstruction. However, the release of LTB4 from BAL cells did not increase.
    In patients with diffuse panbronchiolitis, the number of BAL neutrophils increased and the release of LTB4 from BAL cells was significantly higher than that in asthmatics with bronchiolar obstruction.
    These results suggest that leukotrienes play a role in the pathogenesis of bronchial asthma with hypersecretion.
  • 谷崎 勝朗, 貴谷 光, 岡崎 守宏, 御舩 尚志, 光延 文裕, 杉本 啓介, 横田 聡, 平松 順一, 宗田 良, 多田 慎也, 高橋 ...
    1993 年 105 巻 5-6 号 p. 569-574
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Two asthma classification systems associated with the pathophysiology of the airways were evaluated in 30 adult patients with bronchial asthma. The systems were classification by clinical symptoms (clinical diagnosis) and classification by a score calculated from clinical findings and examinations (score diagnosis).
    Thirty subjects were classified into 15 patients with Ia. simple bronchoconstriction type, 6 with Ib. bronchoconstriction+hypersecretion type and 9 with II. bronchiolar obstruction type by clinical diagnosis. Fifteen subjects with type Ia comprised 10 patients with expectoration of 0-49ml/day and 5 of 50-99ml/day. The patients with expectoration of 50-99ml/day were classified as type Ib by score diagnosis.
    The value of FEV1.0% was significantly lower in patients with type II than in those with type Ia. The value of %V25 was significantly lower in patients with type II asthma compared with type Ia and type Ib subjects. No significant difference was observed in the values of % FEV1.0% and %V25 between patients classified by clinical diagnosis and score diagnosis.
    The proportion of neutrophils in BAL fluid was significantly higher in patients with type II compared to those with types Ia and Ib by both classification systems. The proportion of eosinophils in BAL fluid was significantly higher in types Ia-2 and Ib by clinical diagnosis and in type Ib by score diagnosis than those classified as type Ia-1 by both systems.
  • 松岡 宏明
    1993 年 105 巻 5-6 号 p. 575-587
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    This study examined the correlation between decline in cognitive and motor functions in elderly patients with hypertension. The Mini-Mental State Examination (MMSE) and the Motor Age Test (MOA) were administered to 185 outpatients with hypertension aged 65 or older. In multiple regression analysis, increasing age and history of cerebrovascular disease were significantly related to lower performance on MMSE and MOA. Fewer years of education were also associated with lower performance on MMSE. Vertebral deformity had a significant negative effect on MOA. After controlling other variables, there was a significant correlation between performances of MMSE and MOA. The correlation between cognitive and motor function, which was independent of increasing age and cerebrovascular disease, may indicate common pathogenic mechanisms underlying cognitive and motor deterioration in elderly patients with hypertension.
  • 第1編 ヒト骨髄間質細胞の細胞構成比率,増殖動態及び造血因子産生能に及ぼす加齢の影響
    出口 静吾
    1993 年 105 巻 5-6 号 p. 589-600
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Bone marrow stromal cells (BMSC) play essential roles in hemopoiesis. In the present study, bone marrow specimens obtained from 23 normal volunteers were cultured with a modified version of Dexter's long-term bone marrow culture system to investigate the influences of aging on human BMSC. The composition of BMSC was analyzed by immunofluorescence. The percentage of monocyte/macrophages, adipocytes and T-cells were significantly increased in the aged. BMSC from the aged proliferated more rapidly than those from the young during the first week of culture in the growing dynamics study. Cytokine concentration in the conditioned medium was also measured in terms of BMSC function by radioimmunoassay or enzyme-linked immunosorbent assay. The concentration of macrophage colony stimulating factor (M-CSF) on day 21 increased in the culture from the young, while interleukin-6 (IL-6) concentration was higher on day 7 in the culture from the aged. These findings show no evidence of BMSC defects in the aged. They show evidence suggesting advanced function.
  • 第2編 高齢者骨髄間質細胞の増殖動態並びに造血支持能に及ぼす抗白血病剤の影響
    出口 静吾
    1993 年 105 巻 5-6 号 p. 601-610
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Prolonged marrow suppression after chemotherapy with anticancer agents is often seen, especially in elderly patients. The effects of anticancer agents on the growing dynamics of bone marrow stromal cells (BMSC) in the aged and their ability to sustain the growth of normal hemopoietic progenitor cells (supportability) were examined to investigate the cause of prolonged marrow suppression. Daunorubicin (DNR) suppressed either the proliferation of BMSC or the ability to sustain hemopoiesis as a function of its concentration. Cytosine arabinoside (ara-C) did not suppress growing dynamics or supportability. Methotrexate (MTX) suppressed supportability at higher concentrations, even though it barely suppressed growing dynamics. These results were similar to those from an investigation in younger volunteers. It should be noted that DNR suppresses BMSC function at standard clinical concentrations. However, antimetabolites, especially ara-C are considered comparatively safe drugs for elderly patients.
  • 第1編 びまん性汎細気管支炎患者の気道細胞反応
    白石 高昌
    1993 年 105 巻 5-6 号 p. 611-618
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Diffuse panbronchiolitis (DPB) is known as a chronic progressive inflammation of the peripheral airway followed by lethal respiratory failure. Bronchoalveolar lavage (BAL) was performed to clarify the pathogenesis of DPB compared to chronic bronchitis.
    The recovery rate of BAL fluid in DPB decreased, but total cell count increased enormously. Furthermore, increased proportions of neutrophils in BAL fluid from DPB patients was characteristic and included a relative decrease in alveolar macrophages. Patients with DPB were classified based on the presence or absence chronic airway infection with Pseudomonas aeruginosa. There was no significant difference in cellular components of BAL fluid among the patients with or without Pseudomonas infection. Patients with DPB showed both obstructive and restrictive ventilatory disturbances. There was no correlation between parameters of these respiratory functions and total cell counts or various cellular proportions in BAL fluid. Infiltrating cell density around bronchioles of patients with DPB was measured. Significantly higher cell density was shown in patients with DPB compared to other disease controls. There were also significant negative correlations between cell density and respiratory parameters such as %vital capacity, %V50 and %V25.
    These results indicate that remarkable increase in neutrophils in BAL fluid and the marked cell infiltration around bronchioles in DPB patients could play a crucial role in the pathogenesis of DPB.
  • 第2編 びまん性汎細気管支炎患者の免疫能
    白石 高昌
    1993 年 105 巻 5-6 号 p. 619-628
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    Various immunological processes are suspected of having some relationship with the onset of diffuse panbronchiolitis (DPB). Therefore, the cellular and humoral immunity of patients with DPB were studied. Sera of patients with DPB showed a high frequency of positive RA factor and high titer of cold agglutinin. Delayed skin tests with phytohemagglutinin (PHA) and purified protein derivative (PPD) in patients with DPB revealed normal responses to PHA as nonspecific mitogen and suppressed responses to PPD as specific antigen, although lymphocyte blastogenesis in vitro showed suppressed responses to PHA. The proportion of lymphocytes in bronchoalveolar lavage (BAL) fluid of DPB patients equaled that of normal controls. Furthermore, the CD4/CD8 ratio of T-cell subsets in BAL fluid of DPB patients were significantly lower than that of normal controls, although the CD4/CD8 ratio in peripheral blood of DPB were significantly higher than that in normal controls. The immunoglobulin levels in BAL fluid were significantly higher than normal controls. The percentage of B-cells in the peripheral blood of DPB patients was higher than that in normal controls. These data suggest that the activation of cellular and humoral immune mechanisms could play an important role in the pathogenesis of DPB.
  • 山元 敦也
    1993 年 105 巻 5-6 号 p. 629-639
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    It was previously reported that the elevation of inorganic fluorine level in plasma after inkalation of methoxyflurane causes acute renal failure. This study investigated whether the peak concentration or the duration of the inorganic fluorine is responsible for the renal failure. Continuous infusion (5 millimols/liter and 10 millimols/liter) or a single intravenous bolus injection (720 millimols/liter) of sodium fluoride solution was administered to rabbits. The plasma concentration and the duration of the plasma fluorine was measured.
    There werer no signs of pathological or biochemical changes that suggested renal failure when the peak plasma concentration was less than 50 millimols/liter for over 4 hours (5 millimols/liter, 24 hours), or whether peak concentration of plasma inorganic fliorine was over 50 millimols/liter for less than 4 hours (720 millimols/liter, intravenous bolus). However when 10 millimols/liter of sodium fluoride solution was administered at a speed of 10 milliliters/hour for 24 hours, the rabbits showed a peak plasma inorganic fluorine concentration over 50 micromols/liter for more than 4 hours and signs of renal failure developed ata plasma concentration of 65.8 micromols/liter 24 hours after the beginning of infusion. renal failure was mainly inthe form of edema of the tubular cells in both the cortex and medulla and abnormal biochemical changes (blood urea nitrogen 55.8±12.5 milligrams/deciliter, plasma creatinine 1.2±0.1 milligrams/deciliter).
    Inorganic fluorine can cause renal changes when its paek plasma concentration reaches more than 50 micromols/liter and lasts for more than 4 hours.
  • 山原 茂裕
    1993 年 105 巻 5-6 号 p. 641-647
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
    The difference between stimulative and destructive thyrotoxicosis is usually identified by thyroidal uptake of radioactive iodine, but uptake is not always available. At present, there is no reliable in vitro method of differential diagnosis of thyrotoxicosis. We conducted an investigation of an in vitro method of differential diagnosis of thyrotoxicosis by inhibition assay using monoclonal antibodies that recognized an antigan (14kD) differing from thyroglobulin and thyroid peroxidase. The antigen is the soluble material present in the thyroid follicular space, and is detected by immunofluorescent study. We measured the concentration of this antigen in the sera of patients with thyroid diseases by inhibition assay. In sera from patients with destructive thyrotoxicosis, the concentration of the antigen was lower than that in sera from normal subjects and from Graves' disease patients. There was no significant difference between normal subjects and Graves' disease patients. The data suggest that measurement of the antigen in sera from patients with thyroid disease can be useful for the differential diagnosis of thyrotoxicosis.
  • 1993 年 105 巻 5-6 号 p. 649-655
    発行日: 1993年
    公開日: 2009/03/30
    ジャーナル フリー
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