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Volume 51 (1991)
- Issue 6 Pages 601-
- Issue 5 Pages 487-
- Issue 4 Pages 369-
- Issue 3 Pages 249-
- Issue 2 Pages 131-
- Issue 1 Pages 1-
Volume 51, Issue 3
Displaying 1-14 of 14 articles from this issue
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Shuji KIKUSHIMA, Youichi KOBAYASHI, Kozo KURANO, Takashi YAZAWA, Takao ...1991 Volume 51 Issue 3 Pages 249-260
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSTo prevent side effects of adenosine triphosphate (ATP) in terminating paroxysmal supraventricular tachycardia (PSVT), we studied the effects of ATP on the cardiac conduction system and PSVT in 32 patients using dipyridamole (0.1 or 0.2 mg/kg) as a premedication agent. Increasing boluses of ATP (0.025, 0.05, 0.1, 0.2, 0.3, 0.4 and 0.5 mg/kg) were injected during sinus rhythm or PSVT. All PSVTs, including those at the AV node in a reentrant circuit, could be terminated by ATP. The dose with no premedication was 0.17±0.08 mg/kg ; with 0.1 mg/kg dipyridamole, it was 0.08±0.05 mg/kg ; and with 0.2 mg/kg dipyridamole, it was 0.04±0.01 mg/kg (p<0.01) . The maximum AA-interval during sinus rhythm was observed significantly earlier than the PSVT termination point, so maximum automaticity recovery time after termination by ATP alone, or with 0.1 mg/kg of dipyridamole was less than two seconds. Except for premedication with 0.2 mg/kg of dipyridamole, terminating PSVT doses were significantly smaller than the AV blocking doses during sinus rhythm. Noncardiac side effects, such as flush and dyspnea, were observed in all patients after ATP injection without premedication, but disappeared in two cases and were less in all the other patients in the presence of dipyridamole. No side effect required treatment. Thus, an appropriate combination of ATP-dipyridamole for PSVT termination, to avoid long cardiac arrest due to long automaticity recovery time, and AV block after termination ; and to reduce adverse effects is considered to be 0.1 mg/kg. We conclude that the ATP-dipyridamole (0.1 mg/kg) combination can be used effectively and safely to terminate PSVT.View full abstractDownload PDF (1383K) -
Tomoji MOURI, Miyuki ISHIDA, Shuichi FUKADO, Yasuki WATANABE1991 Volume 51 Issue 3 Pages 261-267
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSCross-sectional areas (CSA) of skeletal muscles observed in the CT image at the E10 level of the Erdheim's grid (the level of the lower abdomen) were measured as part of a series of studies to elucidate the development of skeletal muscle in situ. The subjects included 99 healthy adults (50 males, 49 females), grouped into five age groups (thirties, forties, fifties, sixties and seventies) . They were also grouped into three body types (A, C and D) according to their Rohrer's indices. The observed muscles were m. erector spinae, m. iliacus, m. psoas major, m. gluteus maximus, m. gluteus medius, m. gluteus minimus, m. rectus abdominis, m. abdominis internus and m. abdominis transversus. The shapes of these muscles on the CT image were traced and their CSAs were measured. The results were analyzed against the sex, age and body type, and functional differences were considered. Results: 1. The CSA of m. gluteus medius, which was largest, occupied about 33% of the whole CSA of the skeletal muscles. The CSA of gluteus maximus were second largest and occupied about 23%. The CSAs of the iliacus and psoas major occupied approximately 10%. The CSAs of the erector spinae, gluteus minimus and abdominal rectus occupied approximately 5%. The CSAs of the internal abdominis and transversus abdominis occupied about 3%. 2. In general, the CSAs of male skeletal muscle were larger than those of females. This tendency was remarkable in the case of the erector spinae, iliacus and abdominal rectus. The gluteus maximus tended to occupy a relatively larger percentage in females than in males. 3. The whole CSA of the skeletal muscles were largest in the thirties and smallest in seventies and tended to decrease with aging. The decrease with aging were remarkable in the psoas major, gluteal muscles and abdominal rectus in both sexes. The male iliacus was also remarkable for this tendency. 4. The iliacus and gluteus medius were largest in the body type C and the abdominal muscles and erector spinae were largest in body type D in both sexes. The gluteus maximus muscle was largest in body type C in males and in body type D in females.View full abstractDownload PDF (2033K) -
Hiroshi NOBUSAWA, Reiko HACHISU1991 Volume 51 Issue 3 Pages 268-273
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSTumor-specific immunity was induced in C3H mice by immunizing with syngeneic MH134 hepatoma cells. Radiation sensitivity of anti-tumor activity of immunized spleen cells were examined and compared with the radiation sensitivity of the delayed-type hypersensitivity (DTH) -response. The spleen cells were irradiated in vitro, then mixed with the tumor cells. DTH-response intensity was determined from the footpad increment twentyfour hours after inoculation of tumor cells with immunized spleen cells. Anti-tumor activity of the spleen cells, based on growth inhibition of tumor cells, was measured by a cytostatic test in vivo with diffusion chambers. Tumor-specific DTH response was suppressed dose-dependently in the range of 12-24 Gy irradiation. No suppression was observed below 12 Gy. Without irradiation, growth of tumor cells was inhibited by immunized spleen cells more effectively than by normal spleen cells. Anti-tumor activity of immunized and normal speen cells was diminished by irradiation doses of 20 Gy and 10 Gy, respectively. After considering our with other reports that analyzed the type of anti-tumor effector cells induced in this experimental system, we concluded that tumor-specific anti-tumor activity (tumor growth inhibition in vivo) that was radiosensitive at 10-20 Gy depended on a DTH-response.View full abstractDownload PDF (696K) -
Yoshio MIYASHITA, Tatsuya AKAMATSU, Kazunori KOMATSUZAKI, Toshio AKIYA ...1991 Volume 51 Issue 3 Pages 274-280
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSTo determine circadian rhythm of steroid levels in normal pregnant women, the following study was undertaken. Concentrations of cortisol (F), pregnenolone-sulfate (P5-S), DHA, and DHA-S, which are considered to be secreted from adrenal glands, were measured by GC-MS in 9 normal pregnant women at 3 hour intervals through 24 hours. Except for DHA-S, a similar circadian rhythm tendency was observed for each steroid in the first second and third trimesters. The concentrations of F and DHA peaked at 6: 00 and the circadian rhythms of both steroids were similar, but P5-S reached a maximum level at 9: 00, which was different from F and DHA. DHA-S levels, however, did not fluctuate with a definite circadian rhythm. ACTH was given to normal pregnant women at 12 and 30 weeks of gestation. A significant increment of F and DHA values was observed after administration of ACTH. Although, there was no apparent change of DHA-S in response to ACTH stimulation, low response was observed in P5-S. These results suggest that the adrenocortical steroids measured each has its own circadian rhythm. The secretion patterns of F and DHA from the adrenal gland were similar but different from those of P5-S and DHA-S. Circadian rhythm of steroid concentrations in maternal plasma during pregnancy were demonstrated.View full abstractDownload PDF (684K) -
Yusuke TAKAMIYA1991 Volume 51 Issue 3 Pages 281-288
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSIn consideration of the conditions at our university hospital, we produced a cancer pain relief manual. From April 1989 to March 1990 we studied 87 patients who were admitted to this hospital with cancer pain and referred to the pain clinics. The 3-step analgesics ladder of the WHO was adopted as a model. However, the manual differed in the following 4 points: (1) in step 2, buprenorphine was used instead of codein, (2) in steps 2 and 3, we strongly suggested continuous subcutaneous infusion, (3) oral administration was performed 4 times per day, (4) from step 1, combined treatment with nerve block therapy or radiotherapy was considered. The severity of pain was rated on a scale of 0-10. The effectiveness of the pain control was determined from the mean pain score. Relief was effective in every case ; it was extremely effective in 76 cases, effective in 10, and slightly effective in 1. Although the usefulness of this manual was demonstrated by results in almost all patients, there were 11 cases in which pain was not reduced to 0 despite the administration of high doses of morphine. Six of these cases had direct nerve infiltration, and 5 had pain on movement, due to compression fractures of the metastasized thoracolumbar vertebrae. For these, nerve block therapy or radiotherapy diminished severe pain. Buprenorphine has the following advantages: It is not designated as a norcotic drug, and it produces only mild constipation. Its disadvantages are the existence of the ceiling effect and side effects, such as nausea and vomiting. We strongly recommend continuous subcutaneous infusion, because of its convenience, easy adjustability, and safety against infection.View full abstractDownload PDF (916K) -
Hideaki TAKAYAMA, Junichi NIIKAWA, Taiji KAWADA, Hideki OMACHI, Shigeo ...1991 Volume 51 Issue 3 Pages 289-295
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe histological and biochemical processes of pancreatic regeneration were investigated during their time course after a sigle intraperitoneal administration of DL-ethionine. There were 3 dose groups : 20 mg, 40 mg, 60 mg/100 g body weight. Acute pancreatitis was observed in the 40 mg and 60 mg groups, but not in the 20 mg group. The maximum levels of mitotic index, DNA synthesis rate and labeling index were correlated with ethionine dose. In the 40 mg and 60 mg groups, the change of DNA synthesis rate had a single peak, which reflected mainly the regeneration of acinar cells on an autoradiogram. It was concluded that the activity of pancreatic regeneration could be regulated by the severity of pancreatic damage.View full abstractDownload PDF (6330K) -
—DIFFERENCE BETWEEN ENTERAL NUTRITION AND PARENTERAL NUTRITION—Tsukasa ITOU, Tsutomu KAETSU, Masatoshi KAWAMURA, Kazunari ARAI, Yasus ...1991 Volume 51 Issue 3 Pages 296-302
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe serial change of serum lipids were examined in patients with laparotomy suffering from gastric cancer. The patients were classified into two groups by their nutritional condition : one was enteral nutrition, and the other was parenteral nutrition. In the enteral nutrition group, pre-operation serum cholesterol of 206.7±31.9 mg/dl, dropped to 135.9± 26.1mg/dl on 3 days after the operation. The cholesterol then increased gradually, and recovered to 73.8 % of the pre-operation value 14 days after the operation. Pre-operation cholesterol of 155.0±32.0 mg/dl in the parenteral nutrition group dropped to 106.7±24.5 mg/dl, and then recovered rapidly to 153.5±29.0 mg/dl 14 days after the operation. Serum free cholesterol and phospholipid changed in almost the same way. The serial change of serum HDL-cholesterol was different from that of serum cholesterol. In the enteral nutrition group, the pre-operation value decreased gradually to the lowest value of 32.3±12.1 mg/dl 7 days after the operation. The degree of decrease in the parenteral nutrition group, was smaller than that in the enteral nutrition group. The pre-operation value of 35.6+11.0 mg/dl dropped to 30.2±7.6 mg/dl and recovered to 93.5 % of the pre-operation value 14 days after the operation. The changes of apo-A-I in the two groups were almost the same way as that of serum HDL-cholesterol in each group. The number of cases in which intermediate low density lipoprotein (IDL) increased after the operation were : 2 of 15 cases at pre-operation to 10 of 15 cases at 7 days after operation in the enteral nutrition group ; and 4 of 18 at pre-operation to 6 of 18 7 days after operation in the parenteral nutrition group.View full abstractDownload PDF (3277K) -
Takuya UMEZAWA, Katsumi ASANUMA1991 Volume 51 Issue 3 Pages 303-309
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSHistopathological examination of the upper airway was performed on 71 autopsied infants, of whom 61 cases died during conventional mechanical ventilation in the neonatal period at Matsudo municipal hospital. Results are as follows : 1. Necrotizing tracheobronchitis (NTB) was found in 47 cases (66 %) . Of those 18 cases (38 %) were Grade 1, 15 cases (32 %) were Grade 2, 14 cases (30 %) were Grade 3. 2. There were, statistically, more NTB lesions at the carina and mainstem bronchi of the total upper airway. 3. Of the clinical factors affecting mean airway pressure (MAP), the NTB group was statistically higher than the non-NTB group. The non-NTB group score of inflammatory change was statistically higher than that of the NTB group, which was correlated with the degree of NTB lesion. 4. High-frequency oscillation (HFO) was not obviously related to the occurrence of NTB. We conclude that tracheal perfusion volume is related to the occurrence of NTB, and infectious factors are correlated with the severity of NTB.View full abstractDownload PDF (4124K) -
Yuki NISHIMURA, Shinichi KOBAYASHI, Tatsuhiko KURATO, Eiji UCHIDA, Haj ...1991 Volume 51 Issue 3 Pages 310-318
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSIn Japan two poison information centers have been founded in Tsukuba and Osaka. These centers offer information about intoxication by telephone. No system to identify and quantify a toxin (s) are yet established for rapid and adequate medical treatment of acute intoxication. To set up a poison control center in Showa University, to be operated in cooperation with experts in the medical and pharmaceutical professions, we sent questionnaires to survery the present status of poisoning to 49 clinical departments in Showa University Hospital and two hospitals affiliated with the university. Twenty eight departments (57.1 %) answered the questionnaires. Eighty one cases of acute intoxication by prescribed drugs and 20 cases by toxic chemicals were experienced in one year. To start treatment of these intoxicated patients, more than half of the clinicians sought“consultations with experts”and“information in the literature”. Every department (100 %) answered“necessary”to establish a system for the treatment of intoxicated patients. They (100 %) also answered“necessary”to improve education of students on drug- and chemical-intoxication. The results of the questionnaires show the necessity of a system to contribute to adequate medical treatment of poisoning and improvement of education.View full abstractDownload PDF (1073K) -
Saeko IJI, Reiko TACHIBANA, Yuzo MOURI, Chisato SHIMADA, Kazumasa YASU ...1991 Volume 51 Issue 3 Pages 319-323
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA 21-yr-old woman was anaesthetized for repair of PDA. Although she was ventilated artificially, her left lung expansion deteriorated one hour after the operation. The chest X-ray showed atelektasis of her left lung. A 3 cm long left bronchial stenosis could be seen at a point approximately 1.5 cm from the carina, using a broncho fiber scope. Tomography, Computed Tomography, and Magnetic Resonance Imaging revealed an enlarged right pulmonary artery that caused the bronchial stenosis. On the third postoperative day, the left lung developed atelektasis because of the left bronchial stenosis. We were able to cure the atelektasis by physiotherapy, postualdrainage with a broncho fiber scope. If we had known of the left bronchial stenosis, we could have provided much better postoperative respiratory care. We should examine the effects of vascular system changes on respiratory function before open heart surgery.View full abstractDownload PDF (4532K) -
Hazime TAKAGI, Shigeru ENDO, Norihiro KANEKO, Minehiko YAMADA, Hidehik ...1991 Volume 51 Issue 3 Pages 324-327
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThis case was a 60 year old man whose complaints were coughing, high fever and weight loss. A bilateral diffuse coin lesion was discovered in his chest X-ray. Because the sputum cytology was class V (squamous cell carcinoma), a metastatic lung tumor was suspected, but we could not find the source after many special examinations. It was decided that the source was in the lung. During autopsy, we found adenosquamous carcinoma in the pancreas, kidney and bilateral lungs. It was decided that the source of the metastatic lung tumor of the adenosquamous carcinoma was in the pancreas. This was a rare case.View full abstractDownload PDF (3598K) -
Hiroshi TAKEMURA, Kazumasa YASUMOTO, Akiyoshi HOSOYAMADA1991 Volume 51 Issue 3 Pages 328-330
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe pulse oximeter, which is non-invasive and able to monitor oxygenation continuously, is popular in operating theaters and intensive care units. We compared an accurary of three new type pulse oximeters such as NONIN8700, 8500, and 8604D-LM (NONIN USA) with Biox3700 (Ohmeda USA), the accurary of which had been already evaluated by some authors. Two patients who had respiratory disease, five operated patients who had no history of cardiovascular or respiratory disease, and six normal volunteers participated in the study. The values of the NONIN8500 and NONIN8604D-LM were highly correlated with that of the Biox3700. But the NONIN8700 tended to read slightly higher than the Biox3700, because of differences in their moving averages.View full abstractDownload PDF (320K) -
Sayoko MINAMISAWA, Masahiko IWANAGA, Tomoyuki UMEDA, Yoshihiro WATANAB ...1991 Volume 51 Issue 3 Pages 331-335
Published: June 28, 1991
Released on J-STAGE: November 19, 2010
JOURNAL FREE ACCESSA case of adult T-cell leukemia virus (ATLV) carrier associated with strongyloidiasis and pulmonary tuberculosis was reported. A 48-year-old female who traveled to Okinawa 15 years ago was admitted for further evaluation of abdominal fullness and diarrhea that had lasted for 6 years, and cough and sputum that had lasted for 3 years. Chest X-ray on admission revealed right pleural effusion, and strongyloides stercoralis were then detected in the stool. These symptoms except the cough and sputum were improved by treatment with mebendazole and piruvinium pamoate. Mycobacterium tuberculosis was then detected by 8 weeks culture of sputum, caused by pulmonary tuberculosis. In addition, she was afflicted with primary hypothyroidism and tested positive for HTLV-1 antibody. No pathological lymphocytes were found in her peripheral blood so a diagnosis of ATLV carrier was made. It was suggested that the continuous infection of ATLV induced immunosuppression and was thereby important in the development of strongyloidiasis and pulmonary tuberculosis.View full abstractDownload PDF (1929K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1991 Volume 51 Issue 3 Pages 364-368
Published: June 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSDownload PDF (647K)
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