Okayama Igakkai Zasshi (Journal of Okayama Medical Association)

Studies on immunological aberration and its pathogenetic roles in patients with systemic lupus erythematosus

Part 1. Studies on antilymphocyte antibody

Zenichi NAKAMURA

1981 Volume 93 Issue 3-4 Pages 191-201
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_191

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To determine whether antilymphocyte antibody (ALA) of the sera from patients with systemic lupus erythematosus (SLE) plays any role in immune dysregulation, I checked the ALA titers in various diseases by the cytotoxicity test and the correlation between titers of ALA and clinical activities of SLE.
ALA was detected in 87.5% the total number of SLE patients, in 100% of them during the acute phase, and its frequency and titer were much higher than in other ALA positive diseases. Concerning the relation between ALA titers and several parameters expressing various clinical stages of SLE, I found that titers of ALA were significantly higher in SLE patients with shaggy and diffuse patterns of antinuclear factor (ANF), high anti-ssDNA antibody activities, hypergammaglobulinemia and low complement levels (CH50). These data show a significant correlation between the titers of ALA and clinical activities in SLE; namely the titer of ALA of sera obtained during the acute phase was significantly higher than those of sera obtained during remission.
Moreover, anti-T cell antibodies were detected with high frequency in sera from patients with SLE during the acute phase. These data suggest that ALA plays a pathogenetic role in SLE.

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Studies on immunological aberration and its pathogenetic roles in patients with systemic lupus erythematosus

Part 2. Studies on suppressor T cell function

Zenichi NAKAMURA

1981 Volume 93 Issue 3-4 Pages 203-217
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_203

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Peripheral mononuclear cells from patients with systemic lupus erythematosus (SLE), when incubated for 48hr with or without concanavalinA (ConA), were found to be capable of inhibiting the pokeweed mitogen (PWM)-induced polyclonal immunoglobulin (Ig) secretion of cells from normal individuals. Furthermore, anti-T cell antibody in sera from patients with SLE could not preferentially kill the precursor cells of ConA-induced suppressor cells. However, in SLE these suppressor cells did not significantly affect the Ig secretion of autologous B cells.
These results suggest that defective suppressive activity in patients with SLE does not occur at the T cell level, but that it is most likely due to the defect of B cells in recognizing suppressive information from suppressor T cells, which is caused by in vivo polyclonal B cell activation.

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Experimental Study on Inorganic manganease and Organic manganease (MMT) intoxication

1 Comparison between the effects of MMT and MnCl₂ on oxidative phosphorylation of isolated rat liver mitochondria

Keijiro MORITA

1981 Volume 93 Issue 3-4 Pages 219-225
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_219

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Methylcyclopentadienyl manganease tricarbonyl (MMT) has been developed and used increasingly as a replacement for tetraethyl lead which has been widely used as an antiknock agent of gasoline, or as a fuel oil combustion improver.
We, therefore, investigated the effect of MMT on oxidative phosphorylation and K release of mitochondria as an index of toxic effects on biomembranes.
The concentrations of solution used were 0.10, 0.25, 0.40 and 0.50 mM.
Results obtained were as follows.
1. MMT activated state 4 respiration at more than 0.20 mM solution, i. e. showing the uncoupling phenomenon.
2. Mitochondrial oxidative phosphorylation with MMT was greater than with MnCl.
3. Both MMT and MnCl2 induced K release from mitochondria, and a dose-response relationship between K release and MMT was recognized.
4. It was considered that one reason for the remarkable difference in uncoupling between MMT and MnCl2 was the difference in lipid affinity.

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Study of blood coagulation and fibrinolytic activity following Cardiopulmonary bypass

Kazuo NAKANO

1981 Volume 93 Issue 3-4 Pages 227-247
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_227

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This study measured blood coagulation parameters (especially antithrombin III (ATIII) and α₂ macrogrobulin (α₂ MG) in man to clarify the behavior of blood coagulation and activity corresponding to extracoporeal circulation (ECC).
Patients who were operated on under ECC were classified into three groups according to the time of ECC as follows, Group I less 60 minutes, Group II 60 to 120 minutes and Group III more than 120 minutes.
Results: 1) Blood coagulation activity returned to the preoperative value within 24 hours after operation in each group. Although AT III had recovered within 24 hours, group III remained at lower levels than groups I and II. AT III rose significantly in patients who received warfarin after prosthetic valve replacement and maintained a higher value than those of untreated group. Consumption of AT III was more in mitral valve replacement than in aortic valve.
2) Plasminogen and α₂ macroglobulin fell after operation and required one week to return to the preoperative level and group III showed lower values than the other groups. Fibrin and fibrinogen degradation products (FDP) were elevated longer after operation in group III. These results suggest that prolonged ECC tends to consume much AT III and α₂ MG and to cause to rise in FDP, which may lead to thrombosis and DIC. It would be beneficial to give an anticoagulant drug (warfarin) to maintain higher AT III during the early postoperative period when blood coagulation activity recovers.

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Radioelectrocardiography during exercise. Comparison with the post exercise electrocardiogram

Shunichi KUSUHARA

1981 Volume 93 Issue 3-4 Pages 249-269
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_249

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The exercise electrocardiograms of 295 subjects, 180 males and 115 females, were stud d employing radiocardiography.
The heart rate and electrocardiographic changes during exercise were observed, and com ared with the post exercise electrocardiogram. A lead (CM₅) was monitored continuous and recorded in the control supine and standing position, and in the supine position im ediately after the exercise. The ages ranged from 20 to 74 years (the average was 46.7 11.5 years of age). The subjects were divided into seven groups as follows: 16 patients ith angina pectoris, 46 patients with non-treated and 13 with well controled essential ypertension showing normal electrocardiograms, 17 patients with non-treated essential ypertension accompanied by left ventricular hypertrophy, 37 patients with well controled ssential hypertension and left ventricular hypertrophy, 76 normotensive patients with T-T changes and normal QRS waves and 90 healthy subjects. As a rule, they were sub cted to the Master's test (“augmented” two-step test).
The maximum heart rate during the exercise test differed among the seven groups.
One hundred sixteen out of 295 subjects (39.3%) showed abnormal electrocardiographic esponse to exercise (positive response) after the augmented two-step test according to the riteria used in this investigation. A higher prevalence of electrically abnormal response as observed in cases in whom the maximum heart rate during exercise reached above the 0% obtained from Robinson's nomogram. Increase in P terminal force in V₁ lead was bserved more frequently in the positive response cases than in the negative.
An increase in R wave amplitude (CM₅ lead) during the exercise test was observed freuently in patients with angina pectoris.
It was seen in the other groups less frequently.

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Exercise vectorcardiogram in diabetic patients

Taiji SOGO

1981 Volume 93 Issue 3-4 Pages 271-314
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_271

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The myocardial damage in diabetic patients was evaluated by both resting and exercise vectorcardiograms. Exercise vectorcardiograms were obtained in the supine position by a submaximal exercise test using a bicycle ergometer from 65 patients with diabetes mellitus, 10 with ischemic heart disease, 8 with essential hypertension and 20 normal controls. To investigate the cause of myocardial damage in diabetic patient, vectorcardiograms (VCG) of dogs which had been injected with allylamine intravenously, were recorded. The results were as follows:
1. QRS bites defined as deviation from a smooth conture of the VCG loop with a duration longer than 2 msec and an amplitude greater than 0.05 mv were observed more often in diabetic patients than in normal controls.
2. The prevalence of the QRS bite increased along with an increment in the duration of diabetes mellitus and in the frequency of diabetic microangiopathy of ocular fundus.
3. The magnitude of the QRS bite increased with exercise, both in diabetic patients with an abnormal resting ECG and in patients with a normal resting ECG and a vectorcardiographically abnormal response to the exercise.
4. Diabetic patients frequently showed ST, T changes in VCG after exercise regardless of the resting ECG.
5. Repeated intravenous injection of allylamine frequently caused QRS bite in the VCG of dog's.
6. Pathological studies on the myocardium of the dog showing bite in VCG revealed lesions characterized by subendotherial proliferation of mononuclear cells, mainly in small intramural coronary arteries 100-200 μm in diameter.
The results suggest that microangiopathy of the myocardium would be responsible for diabetic myocardial damage.

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A study on the position of chest electrodes for the Frank lead system

Part I. A study using a human torso model

Minoru MIYASAKA

1981 Volume 93 Issue 3-4 Pages 315-326
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_315

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The effect of horizontal displacement of chest electrodes C, A and I for the Frank lead system on transfer impedance was studied in a human torso model.
The results obtained were as follows:
1) With electrode C displaced 2 cm to the right of its original position, the magnitude of transfer impedance of lead Z increased by 6.3% and the azimuthal angle of transfer impedance of lead X deviated by 3.7%. A displacement of 2 cm to the left caused a decrease in the magnitude of the transfer impedance of lead Z of 5.6%. On the other hand, backward deviation changed the azimuthal angle of the transfer impedance of lead Z by 2.8°.
2) By moving electrodes A and I forward simultaneously by 2 cm the magnitude of the transfer impedance of lead X increased by approximately 5% while 2 cm backward-displacement of the electrodes decreased the magnitude of the transfer impedance of lead X by 5.7%.
3) With the center of the heart approaching the precordial wall, changes observed in 1) and 2) became conspicuous when the electrodes were on the left but obscure when the electrodes were located backwards or to the right.

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A study on the position of chest electrodes for the Frank lead system

Part II. A clinical study

Minoru MIYASAKA

1981 Volume 93 Issue 3-4 Pages 327-341
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_327

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Vectorcardiograms with the Frank lead system were recorded in 122 healthy subjects (65 men, 57 women) and the effect of horizontal displacement of chest electrodes C, A and I on the vectorcardiogram was studied.
The results obtained were as follows:
1) With electrode C displaced 2 cm to the right of the original position, Rz, Sz, and Tz increased, the azimuthal angle of QRSmax deviated backward and the QRS-T angle increased. Almost contrary changes were observed with displacement 2 cm to the left.
2) Rx, Tx, QRSmax and Tmax increased with simultaneous forward dislocation of electrodes A and I, but decreased with backward displacement of the electrodes. A greater influence on the direction of vectors was caused by shifting the electrodes backward. However, the elevation of QRSmax, the azimuthal angle of Tmax and spatial QRS-T angle changed slightly.
3) Changes greater than 1.0 mV and 10% in one of the parameters (Rx, Rz, Sx, QRSmax, Tx, Tz, Tmax) were observed in 35-45% of the subjects with a 2 cm horizontal displacement of electrode C, while an identical displacement of electrodes A and/or I caused the changes in more than 80% of the subjects.
4) Therefore, in clinical use, it is acceptable to vary the position of electrode C horizontally within 1cm from the original position in man and within 2 cm in women.

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Morphological study on the distribution of cardiac ganglia

Matsusaburo TSUBOTA

1981 Volume 93 Issue 3-4 Pages 343-359
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_343

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Serial sections of rat heart and adjacent organs including large vessels and trachea were made and the distribution of cardiac ganglia was investigated by a drawing reconstruction method. The following results were obtained.
1) Cardiac ganglia were not found at the peripheral region of aorta and arch of aorta.
2) They were not found at the bifurcated region of the trachea, but small ganglia were distributed around the bronchi.
3) Small ganglia were also observed in the wall of pulmonary artery distal to the bifurcasion.
4) Many ganglia of different sizes were gathered in the region between the conflux and the opening of pulmonary vein.
5) They were not observed in either atria or ventricles, anuli fibrosi and the impulse conducting system.
The comparative anatomy of the distribution of cardiac ganglia in other mammals was discussed.

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Quantitative Studies on Bleomycin-Induced Strand Breakage of Chromatin DNA

Kazuhiro KATAOKA

1981 Volume 93 Issue 3-4 Pages 361-381
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_361

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Single and double strand breakage of DNA by bleomycin under various conditions was analyzed quantitatively using purified simian virus 40 (SV 40) DNA and SV 40 chromatin. The method employed for DNA assay was fluorometry of SV 40 DNA separated into three forms I, II, and III by 1.4% agarose gel electrophoresis and stained with ethidium bromide. This method was extremely simple and accurate for quantitative estimation of single and double strand breakage of circular DNA. The amount of bleomycin required for in vitro breakage of SV 40 chromatin DNA was much higher than that of naked SV 40 DNA. 2-Mercaptoethanol accerated bleomycin-induced DNA strand breakage. The concentration of 2-mercaptoethanol required for the acceleration was higher in SV 40 chromatin than in SV 40 DNA. DNA strand breakage was induced by ferrous ions in the absence of bleomycin to a similar level in SV 40 chromatin and in SV40 DNA. The acceleration of bleomycin-induced strand breakage by a low concentration of ferrous ion was higher in SV 40 DNA than in SV 40 chromatin. Ethylenediaminetetraacetic acid (EDTA) and copper ions were not efficient for stopping the reaction of bleomycin-induced DNA breakage.
Sodium dodecyl sulfate (SDS) was a useful reagent for stopping the reaction.

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Studies on aging of the pancreas

Part I Changes in exocrine pancreatic function with aging Physiological range of the pancreozymin-secretin test in each age group

Kuniki MISHIMA

1981 Volume 93 Issue 3-4 Pages 383-395
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_383

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There have been many reports on aging of the pancreas; decrease in weight, atrophy and fatty degeneration of the acinal cells, increase of the interacinar connective tissue, arteriosclerosis and so on. However, only a limited number of reports have been published on changes in the exocrine pancreatic function as related to aging and these results are controversial. Furthermore reports on morphological changes of the pancreas, especially of the pancreatic duct, have been limited to a small number of studies with histological evaluation.
The purpose of the present study is to elucidate morphological as well as functional changes of the aging pancreas in the light of recent developments in thinking of: (1) functional changes of the exocrine pancreas as evaluated with the pancreozymin-secretin test; (2) morphological changes of the pancreatic duct as evaluated with endoscopic retrograde cholangiopancreatography; (3) correlation between functional and morphological changes.
The present paper is concerned with studies on changes of the exocrine function of the aging pancreas as evaluated with the panceozymin-secretin test according to the modified Sun-Shay method.
The material was taken from healthy controls accommodated in an old-age home, healthy controls hospitalized for routine annual check-ups, and patients who had no abdominal or metabolic disease. The 60 controls were subdivided into three groups according to age for comparative studies: 21 to 40 years of age; 41 to 60 years of age; older than 60 years of age.
The following conclusions were made:
(1) A significant decrease in the exocrine pancreatic function was observed with aging.
(2) The decrease of exocrine pancreatic function with aging was unrelated to the body weight of controls, the doses of pancreozymin and secretin determined according to the body weight, sex, or the history of alcohol ingestion in cases where daily intake was limited to less than 33 g of ethanol.
(3) Because of the decrease in exocrine pancreatic function, physiological ranges of secretory volume, maximal bicarbonate concentration, bicarbonate output and amylase output on the pancreozymin-secretin test were determined for each age group.

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Studies on aging of the pancreas

Part II Morphological changes in endoscopic retrograde pancreatograms with aging

Kuniki MISHIMA

1981 Volume 93 Issue 3-4 Pages 397-408
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_397

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In the previous report (Part I), it was shown that the exocrine pancreatic function decreases significantly with aging.
The present paper is concerned with studies on morphological changes of the pancreatic duct as evaluated by endoscopic retrograde cholangiopancreatography (ERCP).
Among 2500 patients on whom ERCP had been performed, 100 were selected who showed no abnormalities in serum amylase, urine amylase and pancreozymin-secretin test (PS test). The patients were subdivided into three groups according to age in order to elucidate the morphological changes on the pancreatograms with aging: younger than 40 years of age; 41 to 60 years of age; older than 60 years of age. The length and diameter of the main pancreatic duct, diameter of the accessory pancreatic duct (Santorini), and the presence or absence of tortuosity and irregularity in the margin of the pancreatic duct.
The following conclusions were made:
(1) The length of the main pancreatic duct was 16.4+2.2cm (mean+S. D.), and no significant difference was observed among each age group or between males and females.
(2) The main pancreatic duct had the largest diameter in the head, gradually tapering off in the body and tail of the pancreas. The diameter of the main pancreatic duct showed a significant increase with aging.
(3) Irregularity of the margin and tortuosity of the main pancreatic duct and branches were observed in a significantly increased frequency with aging. These abnormalities, however, were mild.
(4) The accessory duct was observed in 28% of cases; the mean length was 2.5cm, the mean diameter was 1.3mm.
(5) In consideration of the morphological changes on pancreatograms with aging, physiological ranges in the diameter of the main pancreatic duct were determined.

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Studies on aging of the pancreas

Part III Correlation of functional and pancreatographic changes with aging

Kuniki MISHIMA

1981 Volume 93 Issue 3-4 Pages 409-430
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_409

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The previous reports revealed that the aging pancreas showed a significant decrease in the exocrine function as evaluated by the pancreozymin-secretin test and that dilatation, totuosity and irregularity of the margin of the pancreatic duct were more frequently observed with aging.
The present report is concerned with studies on the correlationship between changes in exocrine pancreatic function and pancreatogrms with aging.
The material was taken from 117 patients hospitalized for routine annual check-ups and those with no abdominal or metabolic diseases on whom pancreozyminsecretin tests and endoscopic retrograde cholangio-pancreatography were performed after a short timelag. Evaluated were 4 factors by the pancreozyminsecretin test (secretory volume, maximal bicarbonate concentration, bicarbonate output, and amylase output) and 4 factors on pancreatograms (diameters of the main pancreatic duct in the head, the body and the tail of the pancreas and the presence or absence of irregularity of the margin of the pancreatic duct).
The following conclusions were made:
(1) The exocrine pancreatic function decreased significantly with aging. The main pancreatic duct also showed significant dilatation with aging. A clear-cut correlation was observed among aging, decrease in exocrine pancreatic function and increase in the diameter of the pancreatic duct.
(2) Cases with a decrease in exocrine pancreatic function as well as irregularity of the margin of the main pancreatic duct were observed in an increasing frequency with aging.
(3) It was concluded that aging, exocrine pancreatic function and pancreatographic findings are closely related and that there is a clear-cut parallelism between aging in the exocrine pancreatic function and that in the pancreatic duct as revealed on pancreatograms.

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Studies on paranumerical changes of blood monocytes in bronchial asthma

Part 1. Studies on the direct counting method of blood monocytes

Katsumi AKAGI

1981 Volume 93 Issue 3-4 Pages 431-441
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_431

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A new, simple method for direct count of blood monocytes, was developed using alphanaphthyl butyrate and hexazonium pararosaniline. This method enables us easily to differentiate monocytes specifically stained red-brown from other white blood cells in the same manner of enumeration of WBC.
The average of absolute monocyte count in 40 healthy volunteers was 245±91/cmm, slightly less than the number indirectly calculated from May-Giemsa stained smears and slightly greater than the number from peroxidase stained smears. In general, this new method seemed to be as reliable as the indirect method differentiating 1, 000 leukocytes or more in blood smears. Thus, the method described in this paper can be used in ordinary laboratories and is also applicable to identification and enumeration of macrophages.

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Paranumerical changes of blood monocytes in bronchial asthma

Part 2. Numerical changes of blood monocytes in bronchial asthma

Katsumi AKAGI

1981 Volume 93 Issue 3-4 Pages 443-454
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_443

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Paranumerical changes of blood monocytes were examined using a new direct counting method in 130 asthmatic patients.
The results obtained in this study were as follows.
(1) The number of blood monocytes in the non-attack stage of asthma was less than that in healthy subjects, and the number in the pre-attack stage was approximately the same as the control. The monocyte count in all cases showed a significant increase in preattack and attack stages.
(2) In an individual asthmatic cycle, the number of monocytes tended to increase moderately in pre-attack stages and even more markedly during asthma attacks.
(3) Changes in the number of monocytes in cases with positive bronchial challenge for house dust extract showed the same tendency as in spontaneous asthma attacks.
(4) The number of monocytes did not change in bronchospasm provoked by inhalation of acetylcholine.
(5) Changes in the number of monocytes for exercise-induced asthma patients followed no particular pattern; that is, some cases showed a significant increase in the number of monocytes related to the asthmatic cycle, but other cases did not show any changes.
These findings suggest that the number of monocytes changes in asthma attacks caused by allergic reactions.

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[title in Japanese]

1981 Volume 93 Issue 3-4 Pages 455-463
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_455

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[title in Japanese]

1981 Volume 93 Issue 3-4 Pages 464-471
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_464

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[title in Japanese]

1981 Volume 93 Issue 3-4 Pages 472-479
Published: April 30, 1981
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.93.3-4_472

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