Journal of The Showa Medical Association
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
Volume 50, Issue 5
Displaying 1-20 of 20 articles from this issue
  • Shota ITO, Yuichi NAKANOME, Masao AKIBA
    1990 Volume 50 Issue 5 Pages 463-468
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    We introduce the life of Herman Simon, a famous german psychiatrist, and his activity in his hospital. He left a very impressive description of one bout of depression, We discuss some meanings of his descriptions.
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  • Tomoaki ITAGAKI, Hiroshi CHIBA, Hiroshi SAITOH, Takumi YANAIHARA, Masa ...
    1990 Volume 50 Issue 5 Pages 469-476
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    A significant increment of the release of decidual prolactin (d-PRL) was observed when human decidual tissue was incubated with 10-5M cortisol (F) . However, stimulation by F was diminished by the addition of actinomycin-D. Addition of dehydroepiandrosterone (DHA), DHA-S, estradiol (E2), estriol or beta-methasone did not affect the release of decidual PRL. Eight pregnant women (38-40 weeks gestation) complicated with bronchial asthma were administered 4 mg of beta-methasone, intravenously, 4 hours prior to cesarean section. Maternal venous (MV), umbilical arterial (UA) and umblical venous (UV) blood, and amniotic fluid (AF) and decidual tissue were obtained during cesarean section. PRL, DHA, DHA-S and F values were measured by RIA and were compared with those obtained from controls. Release of PRL into the medium from the decidua was also studied. It was found that PRL levels in MV and AF were significantly lower for patients who received beta-methasone than for the controls, but there were no differences in UA nor UV. F levels in all sources decreased in the treated patients. DHA levels in MV, UA and UV also decreased, and DHA-S levels in MV, UA and AF were found to be lower in the treated patients than in the controls. Release of PRL from decidual tissue obtained from the treated patients, into the medium was lower than that from control tissue. The results indicate that treatment for pregnant woman at term with glucocorticoid suppresses both maternal and fetal pituitary-adrenal functions, which consequently decreases the secretion of steroid including estrogen. Changes of steroid profile may result in changes of PRL levels. An in vitro experiment using decidual tissue demonstrated that the release of d-PRL was stimulated by F, indicating the physiological significance of steroids circulating in the feto-placento-maternal compartment for the control of d-PRL production.
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  • Ryuichi UZAWA, Geong-Gee KIM, Masato HIRASAWA, Jun-ichiro HOSOYA, Yasu ...
    1990 Volume 50 Issue 5 Pages 477-482
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    The nature of the CK-MM subband converting factor was investigated. CK-MM fractions (100% MM3) from myocardial tissue were purified and incubated with the protease fraction or protease free fraction sepatrated from serum. Only the protease fraction could convert the CK-MM subband and included car-N activity. Addition of the car-N activity fraction, collected by gel-filtration of human serum, to the CK-MM fraction (100% MM3), converted the subband from MM3 to MM1 by way of MM3. Conversion of the CK-MM subband was not observed upon addition of the car-N free fraction of human serum. Also, the CK-MM conversion was completely inhibited by the car-N inhibitors, 2-phenanthroline, ε-amino-n-caproic acid and EDTA-2Na except cadmium sulfate. This result seems to contradict the fact that the converting factor of the serum CK-MM subband is a carboxypeptidase-N. It is suspected that other converting factors of the CK-MM subband, which has similar physicochemical properties to the car-N, exist in human blood. The physicochemical property of the unknown CK-MM subband converting factor is similar to carboxypeptidase-K, but its true nature remains to be elucidated.
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  • Hiroshi NISHIHARA, Masahito KAWATANI, Chifuyu TAKESHIGE
    1990 Volume 50 Issue 5 Pages 483-491
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    Immunohistochemical study revealed serotonin like immunoreactivity located at the nerve terminals in the bladder ganglia of the cat. The immunoreactive material surrounded the ganglion cells with a basket like formation. Electrophysiological studies demonstrated that intra-arterial administration of serotonin (40-80nM/kg) produced early onset, large bladder contraction (EC) followed by late onset, prolonged bladder contraction (LC) . EC was abolished by the two 5HT3 antagonists, ICS 205-930 (0.7-352nM/kg) and MDL 72222 (3.2-320nM/kg) . However LC was not changed by these drugs. Serotonin (40-80nM/kg) also produced neural discharge in post ganglionic fibers isolated from the surface of the urinary bladder. These discharges accompanied by the EC were blocked by MDL 72222 (0.4-320nM/kg) . Thus, serotonin induced EC was due to the depolarization of bladder ganglion cells through 5HT3 receptors. Serotonin (0.8-16nM/kg) which was approximately 1/10-1/100 of the dose for bladder contraction, inhibited synaptic transmission at the bladder ganglia. The maximum inhibition was induced by 0.5-1 Hz stimulation and maximal intensity. High frequency as well as supper maximal stimulation reduced this serotonergic inhibition. The inhibition was antagonized by MDL 72222 (3.2-159nM/kg) . Thus synaptic inhibition due to serotonin might be caused by hyperpolarization in the bladder ganglion cells through 5HT3 receptors.
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  • Masafumi WADA
    1990 Volume 50 Issue 5 Pages 492-498
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    Myofibrous organization of 20 adult humans (12 males, 8 females, aged from 29 to 88, average 61.7 years) was studied to identify functional characteristics of m, oblicularis oculi in man. Materials were embedded in celloidin and stained with hematoxylin and eosin. The following results were obtained: 1) Cross-sectional area of the inferior part was larger than that of the superior part, and this tendency was remarkable in males. 2) The number of muscle fibers per sq. mm of the superior tended to be larger than that of the inferior, and no sex difference was observed. 3) The total number of muscle fibers of the inferior exceeded to that of the superior, and those of males exceeded those of females. 4) The muscle fiber size of the inferior was larger than that of the superior. Those of males tended to be larger than those of females. 5) The muscle fiber size of m. oblicularis oculi was smaller than that of other human muscles. Muscle fiber density of the inferior was greater than that of the superior, and those of males were greater than those of females. 6) Correlation between the cross-sectional area and the number of muscle fiber per sq. mm was negative in the superior part and positive in the inferior. There was positive correlation between the cross-sectional area and the total number of muscle fibers in both parts, and no correlation between cross-sectional area and muscle fiber size.
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  • Etsuji TADASHIGE, Masafumi WADA, Makiko HASEGAWA, Takeo TAKAHASHI
    1990 Volume 50 Issue 5 Pages 499-506
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    Histochemical muscle fiber composition was studied in hyoid muscles from 4 rats (2 males, 2 females) . Muscle fibers were classified as white, intermediate and red by lactate dehydrogenase (LDH) activity. The following results were obtained: 1) Cross-sectional area of sternohyoid muscle and the anterior belly of digastric muscle were larger than those of other hyoid muscles, and were remarkably smaller than those of lower limb and trunk muscles. No sex differences were observed. 2) The number of muscle fibers per sq. mm was smallest in omohyoid muscle. Suprahyoid and thyrohyoid muscles were larger than lower limb and trunk muscles. 3) The anterior belly of digastric muscle had the most total muscle fiber, and this was equal to that of sternomastoid muscle which had the least in the lower limb and trunk. 4) The percentages of white muscle fibers were greatest in the posterior belly of digastric muscle, sternohyoid muscle and omohyoid muscle, and the red muscle fiber was most predominant in mylohyoid muscle. Intermediate fibers were most predominant in other muscles. 5) Fiber size of white muscle fibers was largest, and that of red fibers was smallest in each hyoid muscle, and no sex differences were observed. Muscle fiber size was remarkable smaller than that of the lower limb and trunk muscles. Muscle fiber sizes of each types were larger in sternohyoid and omohyoid muscle than in other hyoid muscles. The fiber size in transverse-mandibula muscle was smallest.
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  • Masaki KITAHARA
    1990 Volume 50 Issue 5 Pages 507-512
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    To quantitatively elucidate individual variation in human masseter muscle, the cross sectional area of this muscle was measured in situ with MRI apparatus. The results were analyzed against age, body build and laterality in habitual mastication by bivariate correlation analysis. Materials included 52 healthy volunteers (26 males, 26 females) . Right and left masseter areas and total cross sectional area of the face were measured in the same horizontal plane, and directly displayed on the console of the MRI apparatus. Results: The areas of masseter muscles were not correlated with age or body build, but were positively correlated with the total cross sectional area of the face in the same horizontal plane. Because the left masseters tended to be larger than right, a method for evaluation of the relative size of each side of the masseters was established. This analysis revealed that the corrected dominance of the masseter corresponded, with high probability, to the habitual laterality in mastication.
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  • Ryousuke TATSUKI
    1990 Volume 50 Issue 5 Pages 513-521
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    Myofibrous organization in human diaphragm muscle was studied to ascertain functional characteristics. Materials were obtained from 8 cadavers (ages 46-86, 3 males and 5 females) and separated into sternal, costal and lumbar parts. Muscle fibers were classified as white, intermediate or red by Sudan Black B stain. The following results were obtained. 1) Muscle layers were thickest in the lumbar part and thinnest in the sternal part. 2) The number of muscle fibers per square millimeter was greatest in the lumbar part. 3) The content of fiber types was 2/3 white and 1/3 intermediate. There were remarkably few red muscle fibers (about 1/30) . 4) The sizes of muscle fibers were: largest for white and smallest for red in the costal part ; similar for white and intermediate in the sternal and lumbar parts ; larger in males than in females, especially red muscle fibers. Among the three parts, the smallest fibers were in the lumbar part, for all fiber types. 5) Density of muscle fibers was about 90 % and was similar in the sternal and costal parts, and only slightly less in the lumbar part.
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  • Akiko SAKOH, Akio KOBAYASHI
    1990 Volume 50 Issue 5 Pages 522-529
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    Effects of dietary salt intake on serum concetration and renal excretion of sodium and potassium were studied in seven children with chronic renal failure (CRF) (5 girls, 2 boys) . Ages were 4 to 14 years with a mean of 11 years 9 months, and GFR 2 to 24 ml/min/ 1.48m2. The patients were given an ordinary salt diet (salt intake 4-7.5g/day), a low or nil salt diet (less than 0.5g/day) and a high salt diet (8-15g/day) . Daily protein intake was 1 to 2g/kg body weight and water was given ad libitum. Renal excretion of sodium and potassium was evaluated in terms of clearance (C) and fractional excretion (FE) of both elements. Nine patients who had chronic renal diseases and whose GFR were over 36ml/min/1.48 m2 served as controls. Some CRF patients showed hyponatremia on an ordinary salt diet, which was also seen on a low or nil salt diet and on a high salt diet. The low or nil salt diet significantly increased CNa. Changes in CNa after salt restriction and loading were greater in controls than in CRF patients. FENa increased as creatinine clearance (CCr) was reduced and there was a clear hyperbolic relation between FENa and CCr. Neither salt deprivation nor loading had essential effects on FENa. Serum concentrations of potassium increased as CCr decreased. This finding was also seen during salt restriction and salt loading. CK was low in CRF patients and unchanged during salt restriction and salt loading. CK was significantly higher in controls than in CRF patients both on an ordinary salt diet and on a high salt diet. FEk was increased as CCr decreased, and there was a hyperbolic relation between FEk and CCr during both salt deprivation and salt loading.
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  • —A COMPARATIVE STUDY OF THE EFFECTS OF MOXIBUSTION, ELECTROACUPUNCTURE AND KAMPO-HOZAI OHRENGEDOKUTOH ON DELAYED TYPE HYPERSENSITIVITY IN IMMUNOSUPPRESSED MICE—
    Takako KASAHARA, Yu-xing WU, Ye WANG, Yoshiko SAKURAI, Katsuji OGUCHI
    1990 Volume 50 Issue 5 Pages 530-536
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    We studied the effects of moxibustion, electroacupuncture and kampo-hozai ohrengedoku-toh, a Chinese herb prescription, on delayed type hypersensitivity (DTH) to picryl chloride (PC) in immunosuppressed mice. Six to nine week old male ddY mice were used. PC challenge was administered 6 days after sensitization. The ear swelling induced by PC-DTH was maximally suppressed by cyclophosphamide (Cy, 100 mg/kg) given 4 days after PC sensitization. Stimuli were applied to the point equivalent to the Mingmen point of the human body (on the post meridian line, between the 2nd and 3rd lumbar spinal processes), which Chinese medicine regards to be closely related to immunity. Significant inhibition of DTH suppression was observed when moxibustion (10 mg moxa/mouse), electro-acupuncture (2.5 Hz, 15 min.) or oral administration of kampo-hozai ohrengedoku-toh (prepared in our laboratory) had been applied one time per day for 3 days before PC sensitization. Moxibustion, electroacupuncture (5 Hz, 10 min.) and ohrengedoku-toh did not affect Cy suppressed DTH when they were applied before PC challenge. None of these promoted immunosuppression in a Cy immunosuppressed condition.
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  • Takayasu MUSHIAKI, Kouichi KINOHIRA, Kiyohiko SAIDA, Masahiro AIBA
    1990 Volume 50 Issue 5 Pages 537-543
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    Sequential changes of left ventricular function after cardiac surgery were studied in 53 patients using echocardiography. Surgery for coronary artery bypass grafting (CABG) was performed on 14, mitral valve replacement to mitral stenosis (MS) on 14, to mitral regurgitation (MR) on 9, direct closure of atrial septal defects (ASD) on 6, and double valve replacement (DVR) on 10. The results of this study were as follows. 1) CABG: Ejection fraction (EF), fractional shortening (FS) and stroke volume index (SVI) decreased early postoperatively, and recovered after three months. However, mean velocity of circumferential fiber shortening (mVcf) decreased during three to six months, and recoverd after one year. 2) MS: MVcf increased early postoperatively, but indicated no significant improvement after six months. SVI and cardiac index (CI) improved after one year. 3) MR : Postoperatively, end-diastolic dimension index (EDDI) and SVI decreased significantly. Changes of EF were not significant, but tended to improve after one year. 4) ASD: EDDI, SVI and CI increased two weeks after surgery, and no significant changes were noticed in EF, FS and mVcf. 5) DVR: EF and FS increased one year after surgery. From the these results, the functions of the left ventricle were changed significantly by postoperative therapy during the early postoperative period. Therefore, we conclude that improvement of left ventricular function should be assessed two weeks after cardiac surgery in ASD, six months in CABG and MS, and at one year in MR and DVR.
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  • —SUMMARY OF CASES OPERATED ON IN 8 YEARS—
    Masato SHIRAKURA, Norihiko ASAHINA, Seido OOKI, Naohiko WATANABE, Take ...
    1990 Volume 50 Issue 5 Pages 544-547
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    Tympanoplasty was performed on 88 patients at Fujiyoshida City Hospital between 1981 and 1989. All cases were subjected to operating microscope examination, pure-tone audiometry, bacteriological examination, X-ray examination (plain, tomography), and CT scan. With respect to the classification of tympanoplasty, 40 cases underwent type 0 tympanoplasty (45%) ; 31 cases, type I (36%) ; 5 cases, type III (6%) ; and 12 cases, other types (13%) . We used the Teikyo University method of tympanoplasty since 1985. After using this method, the results of hearing sense were satisfactory; 97% of the patients experienced improvement after operation. Differences between results by skilled operators and beginners were very slight, and time to operate was shorter than by other methods. Operation techniques for middle ear surgery and postoperative care are discussed.
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  • Hisashi OKA, Yasuo ISHIDA, Kiyoto ASAKAWA, Nobuhiro KOJIMA, Seiichi KU ...
    1990 Volume 50 Issue 5 Pages 548-552
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    We report here a case of rectal prosthesis for a patient with lower rectal carcinoma. The patient was a 43 years old male. He complained of bloody stool with tenesmus, which he had been suffering from for about one year. In our department lower rectal carcinoma with remarkable stenosis was revealed by enema and endoscopy. A plain abdominal X-ray also showed a large intestinal content in the entire large intestine. A prosthetic instrume-nt was placed in the stenosis of the rectum. Through the lumen of the instrument, irrigation was avalable in the entire colon for 3 to 4 days after twhich barium enema allowed us get information above the stenosis. As result of the irrigation, the operative maneuver was remarkab-ly fine, and there were no post operative complications. It has been found that flora in patients with cob-rectal cancer is abnormal. It has also been found in our experience the animal studies at incidence of anastomotic leakage without preoperative irrigation was 46.7 % too higher than for the irrigation group. Thus, for a preoprative patient with stenotic rectal cancer, a rectal prosthesis developed by us improves this situation very much. We recommend that preoperative irrigation should be performed for patients with stenotic lumen due to rectal carcinoma.
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  • Seiji NAITO, Akihiro KAWAUCHI, Susumu ANDO, Hirotoshi CHOH, Nobuhiro F ...
    1990 Volume 50 Issue 5 Pages 553-556
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    A 22-year-old man experienced a traumatic deep submandibular foreignbody in a traffic accident. Roentgenogram did not indicate its position clearly, and extraction was tried three times with no success. On using 7.5 MHz high speed mechanical sector scanner, the foreignbody was removed easily. The mechanical sector scanner and linear electric scanner can produce real time images, but they are not available for superficial tissue. In this case a mechanical arch scanner was used because of the advantage of its high resolution when use on superficial tissue.
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  • Atsubumi MURAKAMI, Kohji MORIYASU, Noboru MURATA, Kiyohiko SAIDA, Hide ...
    1990 Volume 50 Issue 5 Pages 557-561
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    A 9 year-old boy was known to have had a heart murmur since infancy. He, however, remained symptom-free until the age of 7 when he developed fever and blood cultures were positive for Streptococcus viridance. Catheterization revealed VSD with MSA and left ventricular right atrium communication. Intraoperative diagnosis was aquired LV-RA communication, infravalvular tricuspid type. Patch closure with double folded xenomedica was performed uneventfully. Severe turbulance predisposes to infectious endocarditis and unlike most ventricular septal defect, LV-RA communicaton has a lower incidence of spontaneous closure. We recommend from our experience, that all these defects be repaired regardless of size.
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  • Katsuhiko YAMADA, Hitoshi MATSUBARA, Masato YAMAMOTO, Hiroki TAZAWA, H ...
    1990 Volume 50 Issue 5 Pages 562-567
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    We experienced a case of leiomyosarcoma of the kidney. The patient was a 78-year-old man with pleural effusion at first admission. A malignant tumor in the left kidney was identified by abdominal CT scan and echogram. After 3 months, he was readmitted with multiple tumors of the lung and pleural effusion. Lung metastasis of the kidney tumor was suspected. The patient died of pneumonia on the 73rd day in the hospital. A 5 × 4 × 4 cm tumor with a definite margin was discovered in the lower portion of the left kidney during histopathology. From the HE-stained cell texture of the kidney tumor, spindle shaped tumor cells containing stick-like nuclei full of chromatin, were grouped in a line, the kidney tumor was diagnosed as leiomysarcoma. Diffuse metastasis was detected in the left lung, pleura, right kidney, 3rd and 9th thoracic vertebrae, the endocardium, etc. There was also evidence of early cancer of the stomach (well differentiated adenocarcinoma, ha) . Leiomyosarcoma is a malignant tumor of the kidney with few clinical symptoms. It is clinically rare (1-3.3% of all malignant kidney tumors) . This was a case of double stomach cancer. Double penile cancer was reported by Kojima et al.
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  • Niichi MIYAMOTO, Atsuko HIRATA, Masazumi OGAWA, Hitoshi NISHIDA, Nobuo ...
    1990 Volume 50 Issue 5 Pages 568-571
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    A 76-year-old woman suspected of having Caroli's disease was admitted to our hospital with complains of abdominal tumor and fever. Although she had undergone cholecy-stectomy at the age of 21 and cystic dilatation of the common bile duct was observed, the diagnosis of Caroli's disease, or disease related to it, was based on the findings of intrahepatic bile duct dilation with stone formation and complication with multiple renal cysts. In general, it is accepted that Caroli's disease is frequently complicated with carcinoma of the hiliary tract, but its pathomechanism has not been elucidated. We analysed the bile acids composition on the assumption that its alteration might be one possible mechanism in the development of carcinoma in this disease, but the analytical result was normal except for the glycine/ taurine ratio of conjugated froms of bile scids. Further comparative study of bile acids composition between cases with and without carcinoma is recommended to clarify the pathomechanisms of the development of malignant tumor in Caroli's disease.
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  • Kazumitsu UEDA, Yoji ITO, Toshiyuki SHIGA, Mutsuo HOKARI, Miki SHIBUSA ...
    1990 Volume 50 Issue 5 Pages 572-574
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    In 1988, a 39 year-old-man was admitted to our hospital with RLQ pain. The next day, he had increasing lower abdominal pain, and small intestine resection was performed. Anisakis was found in the ileum. Anisakiasis infection can be caused by eating raw fish, such as sushi or sashimi. Pathological features of the disease are phlegmonous enteritis, such as edematous thicking of the wall with massive eosinophilic or other cellular element infiltration in all layers. It is difficult to diagnose intestinal anisakiasis compared to gastric anisakiasis, and other differentiated diagnoses of the disease include acute appendicitis, ileus, diverticulitis, and intussusception. Some cases have good prognosis with conservative treatment, but many patients reauire surgical treatment.
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  • Nobuaki SUZUKI, Kunihiko OKUMURA, Nobuo HIROSE, Haruo TAKEUCHI, Yoshio ...
    1990 Volume 50 Issue 5 Pages 575-579
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
    A 31 year-old man was hospitalized for a detailed examination and treatment for repeated attacks of abdominal pain. Barium enema and colonoscopy revealed a 6 × 4 cm sub-pedunculated protuberant lesion with reddish, nodular surface on the ascending colon near the ileocecal valve. Biopsied specimens revealed no malignancy, but an operation was performed since malignancy of the lesion could not be excluded because of its size. No malignancy was found in the resected specimen, and histologically, it was a tubular adenoma with mild atypia. This case was very rare, since most cases of tubular adenomata exceeding 4 cm are associated with cancerous transformation. It was presumed that the abdominal pain experienced in this case was a result of repeated intussusceptions and reduction of the terminal ileum in the colon, which occurred due to the presence of colonic adenoma which was found during the operation, whereas the abdominal pain disappeared completely after the operation.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1990 Volume 50 Issue 5 Pages 580-584
    Published: October 28, 1990
    Released on J-STAGE: September 09, 2010
    JOURNAL FREE ACCESS
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