Although arthrography is an important method for diagnosis of meniscus injuries, some techniques are needed for accurate reading of the resulting arthrograms. To find out what features of an arthrogram were easily misread with respect to differences between the medial and lateral menisci, and between types of tears, we compared preoperative arthrographic findings with intraoperative findings obtained from 54 patients undergoing surgery based on the diagnosis of meniscus injury alone. Arthrograms of 9 of the 54 patients were misread, or difficult to read. These 9 patients had either a torn surface with very complicated features (a bucket handle-like or longitudinal rupture) or a torn fragment displaced a relatively small amount (detachment of a marginal region of the meniscus) . Our findings suggest the importance of standardization of both arthrographic procedure and reading to achieve accurate roentgenographic diagnosis.

View full abstract

Analgesia caused by low frequency stimulation of the acupuncture point (AA), and of the non-acupuncture point after lesioning the analgesia inhibitory system (NAA), was abolished by hypophysectomy. We previously found that the final region of the AA afferent pathway from the acupuncture point to the pituitary gland was the medial part of the hypothalamic arcuate nucleus (M-HARN), and that of NAA afferent pathway was the anterior hypothalamus (NAA-AH) . The initial region of the descending pain inhibitory system involved in AA and NAA was the posterior part of the arcuate nucleus (P-HARN) which is located close to the M-HARN. Effects of 9-endorphin and of ACTH on the neural connection between M-HARN and P-HARN or NAA-AH and P-HARN were investigated to clarify relations between the pituitary gland and AA or NAA. Pain threshold was measured by rat tail flick latency (TEL) . Drugs were applied through fine cannulae to the brain. Animals were classified as responder or non-responder by the presence or absence of significant increase in TFL. Analgesia of the AA responder was not changed, but that of non-responder was changed to that of the responder by 0.5 mg/kg i.p, morphine which produced analgesia equivalent to AA. Naloxone microinjected into the P-HARN dose-dependently antagonized AA (ED₅₀ =1.2 pg) and microinjected morphine (ED₅₀ = 0.6 μg) or j3-endorphin (ED₅₀ = 0.25 μg) dose-dependently produced analgesia and changed non-responders to responders. AA abolished by hypophysectomy was restored by 0.5 mg/kg morphine (i.p.), or morphine (0.5 μg) or 3-endorphin (0.1 μg) microinjected into the P-HARN during acupuncture point stimulation. Dexamethasone, injected i.p. or microinjected into the NAA-AH (ED₅₀=0.12pg) or P-HARN (ED₅₀=0.08 μg), antagonized NAA dose-dependently. ACTH microinjected into the NAA-AH (ED₅₀=0.25 μg) or P-HARN (ED₅₀=0.6 μg) dose-dependently produced analgesia. NAA abolished by hypophysectomy was restored by concurrent application of non-acupuncture point stimulation and ACTH (0.5 μg) microinjected into P-HARN but not into the NAA-AH.The dopamine antagonist, haloperidol, microinjected into the P-HARN antagonized both AA and NAA (ED₅₀=0.35 μg), and dopamine microinjected into the P-HARN dose-dependently produced analgesia (ED₅₀=0.5 μg) . These results imply that : 1) There should be a neural connection between the M-HARN and P-HARN in AA, between the NAA-AH and P-HARN in NAA, and the transmitter might be dopamine. 2) This neural transmission might be available only in the presence of jS-endorphin or ACTH associated with the pituitary gland mechanism. 3) μ-Endorphin and ACTH might act presynaptically in this neural transmission.

View full abstract

The myofibrous organization of the seal inferior constrictor was analyzed to elucidate functional characteristic of the pharyngeal muscle. Subjects were 10 female seals (average 7.0 years and average body weight 31.6 kg) . The pharynx with the larynx was observed macroscopically, and muscle slices of the inferior constrictor were embedded in gelatine and stained with Sudan Black B. The muscle fibers of these transverse sections were classified into three fiber types : white, intermediate and red. The following results were obtained. 1) The inferior constrictor contacts with the middle constrictor at the cranial side but they do not overlap. The muscle fibers are arranged circularly in all parts of the inferior constrictor. 2) The length of the pharyngeal muscle at the raphe pharynx was 58.7 mm and about 52 % of it con-sisted of the inferior constrictor. The average thickness of the muscle layer was 2.8 mm, which was 1.6 times that of man. The average bilateral muscle weight of the inferior constrictor was 6.5 g. 3) The area of the transverse section was 305.0 mm². There were 718 muscle fibers per mm², and a total of 236, 885 fibers in the transverse sectional area. The percentages of white, intermediate, and red muscle fibers were 55.7 %, 26.4 %A and 17.9 %, respectively. In all cases, the white muscle fibers exceeded 50 %. 4) The mean area of the muscle fibers consisted of 1271.7, im² of white muscle fibers, 720.3 im² of intermediate, and 551.3μm² of red. In the normal distribution of the muscle fiber size, white fiber was largest and red fiber was smallest. Occasionally the size of the white muscle fiber had a double low peak pattern. 5) The average density of the muscle fibers was 76.4 % ; consisting of 54.4 % white muscle fibers, 14.3 % intermediate, and 7.7 % red. The fast constriction and strong vermicular movement of the seal inferior constrictor is thus possible because of the remarkable development of the white muscle fibers, the circular arrangement of the muscle fibers and the thickness of the muscle layer.

View full abstract

Comparative effects of Zinc N- (3-aminopropionyl) -L-histidine (Z-103), L-carnosine, and ZnSO₄·7 H₂O on rat erythrocytes and primary cultured hepatocytes were studied. Both Z-103 and ZnSO₄·7 H₂O, in concentrations of 4×10^-5M-1×10^-3M, protected erythrocytes from 50 % hypotonic hemolysis, and 1×10^-3M L-carnosine was also slightly protective. There was a significant decrease in the leakage of GOT from the cultured hepatocytes, compared to that of the control, after treatment with 10^-9 or 10^-6M Z-103, or 10^-6M L-carnosine. However, treatment with ZnSO₄·7 H₂O produced only effects comparable to those in the control. Similarly, decrease in GPT leakage from the cultured hepatocytes was clearly evident after treatment with Z-103, L-carnosine or ZnSO₄· 7 H₂O. There were no obvious effects of these three compounds on surface tension or phase transition temperature of DPPC liposome bilayer. The present results indicate that Z-103 and ZnSO₄·7 H₂O similarly inhibit hypotonic hemolysis and enzyme leakage from cultured hepatocytes. It is suggested that chelated zinc, and not Z-103 itself, is the major factor in changing membrane properties.

View full abstract

Using X-ray CT images, body composition of the cross-sectional area at the level of the 4 th lumber vertebra was studied in 46 humans (26 males and 20 females) who are in the same period of development. The total cross-sectional area of the subcutaneous fat, abdominal cavity, vertebra and muscles (rectus abdominis, abdominis lateralis, quadratus lumborum, psoas major, dorsi proprii) were measured and compared for sex and age. The result were as follows : 1) The increase in the total cross-sectional area was significant in males aged between 10 and 14, although in females the increase was also significant between 15 and 17. 2) The increase in the subcutaneous fat continued untill age 10-14 in males and age 15-17 in females, and this increase was significant in the latter. The muscles and vertebrae increased until 1517 in both sexes, although the increase in the muscle was more significant in males than in females. 3) The abdominal cavity increased in this period of development in both sexes, although the ratio of the total cross sectional areas decreased. 4) Comparison of body composition by age yielded : In males up to ages 10-14, the relative order of size was ; abdominal cavity, muscles, subcutaneous fat and vertebra. In those aged 15-17, the relative order was muscles, abdominal cavity, subcutaneous fat and vertebra. By contrast, in females up to ages 10-14, the relative order was the same as that for males, but in ages 15-17, the subcutaneous fat ratio was largest, followed muscles and vertebra by abdominal cavity. 5) The increase in the muscles during the period of development was continuous in both sexes for every muscle. It was presumed that significant increase occurs in all muscles except the rectus abdominis in males, and only in the dorsi proprii in females during adulthood. 6) The area sizes at all ages, in both sexes were in the order of abdominis lateralis, dorsi proprii, psoas major, rectus abdominis and quadratus lumborum.

View full abstract

To elucidate the characteristics of body composition of the Japanese, we measured body potassium (⁴⁰K) and analyzed its relation to the physique indices including subcutaneous skinfold thickness and lean body mass (LBM) . The subjects were 104 healthy Japanese adults including 17 males and 84 females whose ages ranged between 23 and 74 years (mean : 50.9±12.3) . The following results were obtained : 1. Body potassium (⁴⁰K) was 122±15 g in males and 82±10 g in females. Females older than 60 years had low values of body potassium, which suggested a trend to decrease with age. 2. LBM was 52±5 kg in males and 40±6 kg in females. Slightly larger values of LBM were observed among young females. Males were 14±4 %fat and females were 25±7 %. 3. ⁴⁰K and LBM of both sexes were significantly positively correlated. ⁴⁰K correlated significantly with subcutaneous skinfold thickness and body density only in females. 4. Among the other physique indices, Quetelet's index and Kaup's index were relatively highly correlated with body potassium values. 5. The linear regression expressions from our results to estimate LBM from the body potassium value were : For males; Lm (kg) =0.309 K+14.054 (r=0.9), for females; Lf (kg) =0.302 K+15.388 (r=0.6), for both ; L (kg) = 0.310 K+14.071 (r=0.8), K ; potassium-40 (g) . The short forms of these relations were : For males; Lm (kg) =K/2.4, for females ; Lf (kg) =K/2.0. 6. LBM values estimated from our formula would be lower than those estimated from the formula of Forbes, and would tend to be lower, but not significantly different than those estimated from Boddy's equations.

View full abstract

For chronic empyema of the aged, caused by pleuritis tuberculosis, postartificial pneumothorax and so on, drainage is the first essential treatment. In these cases, long term drainage is very painful, so we replace a trocar catheter with a balloon catheter about three weeks after insertion of the trocar catheter. This method allows us to attach a drain to the skin with adhesive tape, so the patient can live comfortably without pain. Sooner or later, he will be able to be discharged from the hospital with this balloon catheter.

View full abstract

Since 1983, in Suwa Central Hospital, endoscopic laser [Nd-YAG] therapy (ELT) has been used on nineteen patients with gastric cancer (7 cases with advanced cancer, 3 cases with recurrence after operation for advanced cancer and 9 cases with early cancer) . Results of treatment of the seven advanced cases were : Minor improvement of the lesion was found in marcoscopic investigations in 3/7 cases, stenosis was reopened in 3/7 cases, and there were hemostatic effects against bleeding in one case of advanced cancer. We failed to evaluate lifespan prolongation of the above seven cases after ELT. Stenotic lesion was reopened in only one of three postoperative recurrent gastric cancer cases by this therapy. ELT was applied to nine patients with gastric cancer. There was complete remission (CR) in five cases, partial remisson (PR) in one case, minor remission (MR) in one case, and no change (NC) in two cases. The five CR cases included two early cancers with IIa+ IIc, two with IIc, and one with Ha. All of these five cases have survived after ELT to the present time. It is considered that not only elevated lesion, but also depressed lesion should be treated by ELT in early gastric cancer.

View full abstract

We report here a case of primary biliary cirrhosis (PBC) with marked Cu deposi-tion in hepatic tissue. Cu granules were revealed in hepatic cells in the peripheral part of the hepatic lobe in hepatic tissue stained by rhodanine. They were also revealed in Kupffer cell and Macrophages of Glisson's capsules. In further study of 8 other cases with typical PBC, Cu granule deposits were revealed in the peripheral part of the hepatic lobe, which tend. ed to be marked in the progressed stage. However Cu deposition, serous Cu and bile stagnation didn't show parallel courses. Thus, long term bile stagnation with crisis of the interlobu-lar bile duct, affects on Cu deposition in hepatic tissue.

View full abstract

A 48-year-old male with mitral prolapse syndrome underwent severe left heart failure due to rupture of chordae tendineae. The site of rupture was the strut chorda of the anterior leaflet, one third which was prolapsed. We performed mitral valve replacement, and met with good results in this case. Mitral prolapse syndrome caused by myxoid degeneration is progressive, so we must follow up intensively and timely surgical treatment should be performed.

View full abstract

We have experienced two cases admitted to a mental hospital in a prolonged condition of schizophrenia. They experienced morbid images like transient disturbances of consciousnesses, such as disorientation, amnesia and incoherence. After recovery from these symptoms, they experienced other images that suggested an organic defect. From the findings, it was presumed that increasing the dose of antipsychotic drugs leads to exacerbation of the symp-toms, and decrease or discontinuance of antipsychotics or treatment with agents for improving cerebral metabolism and circulation is effective. W e concluded that organic lesion may not always be caught macroscopically, and the presence of multiple infarctions as well as arteriosclerosis and minimal infarction occurring in early stages must not be ignored.

View full abstract