Journal of The Showa Medical Association

COMPARATIVE HISTOLOGY OF THE PATELLAR CARTILAGE DEGENERATION BETWEEN CHONDROMALACIA PATELLAE AND OSTEOARTHRITIS

Minoru KUBO

1994 Volume 54 Issue 6 Pages 307-317
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.307

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A histological investigation of the patella cartilage degeneration between chondro-malacia patellae and osteoarthritis was performed in twenty-five knees of twenty-two young patients who were classified into unstable patella, and in twenty-two knees of twenty-one patients who had total knee arthroplasty. Histology indicated that the degenerative cartilage in chondromalacia patellae could heal either by extrinsic or intrinsic repair (fibrous metaplasia of chondrocytes), and that the degenerative cartilage in osteoarthritis could not heal, and would progress to terminal eburnation.

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THE PHARMACOTHERAPY OF SCHIZOPHRENIA

—The Duration of Neuroleptics in Patients who had Few Relapses—

Yasuo Unai, Takuhiko Murata, Yuichi Nakanome, Tuneo Honda, Tadashi Fur ...

1994 Volume 54 Issue 6 Pages 318-334
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.318

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The purpose of this study was to determine the feasibility of cessation of pharmacotherapy in schizophrenia. This data was collected from Jan. 1, 1978 to May 31, 1993. It covered 30 patients at the Department of Neuropsychiatry, Showa University Fujigaoka Hospital. The diagnosis of schizophrenia was made using criteria of ICD-10. In the course diagnosis of this classification, 22 patients who were defined as “1” type belonged to F20. x2, . x4, . x5 and 8 patients of the “2” type had F20. x3 in ICD-10. The neuroleptic cessation method was divided into four periods of pharmacotherapy : regurate, maintenance, reductive and cessation in the follow up of course from one year to 14 years. Based on this study of relapses in the relation between neuroleptic reduction and withdrawal and the duration of medication, it was found that neuroleptics are necessary in only a few and can be stopped for the “2” type of schizophrenia. Neuroleptics were discontinued in 4.5 % of “1” type schizophrenic patients ; it was difficult to have neuroleptic withdrawal independent of initial attack or relapses. On the other hand, the neuroleptics could be stopped in 62.5 of the “2” type schizophrenic patients. The duration of final medication among the patients in whom neuroleptics could be withdrawn was three years and one week in“1”type schizophrenia and one year and four months on average in“2”type schizophrenia.

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SIMULTANEOUS MEASUREMENT OF HALOPERIDOL AND DOPAMINE IN RAT STRIATUM BY BRAIN MICRODIALYSIS

Akihiko YURA, Yosiko KUDO, Noriyuki NAKACHI, Yukako YAMAZAKI, Masahiro ...

1994 Volume 54 Issue 6 Pages 335-341
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.335

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Brain microdialysis was applied to monitor levels of haloperidol in the rat brain. In anin vitroexperiment, relative recovery through the dialysis membrane was 12-23 % for haloperidol. Using brain microdialysis, we investigated the simultaneous changes of unbound haloperidol and dopamine levels in the extracellular space of the rat striatum after intraperitoneal injection of haloperidol (2 and 5 mg/kg) . After haloperidol injection, the haloperidol concentration in striatal dialysates was increased in a dose-dependent manner, and maximum levels were reached at 90-120 minutes after injection. Thereafter, the haloperidol concentration slowly decreased with a t_1/2of approximately 2.5-3 hours. In contrast, the dopamine levels in the striatal dialysates were increased in a dose-dependent manner up to 8 hours after haloperidol injection, peaking at 344 % (2 mg/kg) and 678 % (5 mg/kg) of basal levels. These findings suggest that brain microdialysis is a useful technique for simultaneous alalysis of pharmacokinetics and pharmacodynamics of centrally acting drugs in the brain.

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PARTIAL RESECTION THROUGH POSTERIOR PROCTOTOMY APPROACH FOR EARLY LOWER RECTAL CANCER

Hisashi OKA, Toyohide NAKAMURA, Shoji SASAYA, Hideaki NAGASAKI, Hidefu ...

1994 Volume 54 Issue 6 Pages 342-346
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.342

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This paper describes the technique of partial resection of lower rectal cancer through a transsacral approach. Relatively small lesions in the lower rectum are, in general practice, removed by an endoscopic procedure like polypectomy. When the lesion is diagnosed as sm carcinoma on the examination of the histologic section of resected tissue, the appropriate therapy suited to the individual patient is chosen from among several alternatives. Partial resection of the lesion can be completed without dissection of regional lymph nodes if the patient is negative for such findings as massive invasion of the stump or its neighboring area, vascular invasion, and poorly differentiated adenocarcinoma. Then are several means of access, to the lesion such as trans-anal, -sphincteral, and -sacral resection. We employ transsacral partial resection in situations which would have in the past been transanal or transsphincteral resection. The reason is in addition to providing an unobstructed view, this technique can be easily changed if Dl regional lymph node dissection is necessary during the operation. Furthermore, prior to operation the periphery of the lesion is market stained, and under direct endoscopic control a clip is attached to precisely locate the lesion.

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A CASE OF RENAL CARCINOMA WITH ANEURYSMAL METASTATIC LESION IN STERNUM

Toshiaki SHINOZAKI, Seiichiro INOKUCHI

1994 Volume 54 Issue 6 Pages 347-350
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.347

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A case of left renal carcinoma with multipule bone metastasis to the ilium, lumbar and thoracal vertebras and sternum is reported. A 61-years old male, the metastatic lesion of the sternum produced an aneurysma-like mass in the subcutaneous tissue of the anterior chest wall, because of hyper vascular of the metastatic lesion.

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A CASE OF HEPATOCELLULAR CARCINOMA COMPLICATED WITH PRIMARY BILIARY CIRRHOSIS

Ichiro USUI, Makoto ONUKI, Hideki OHTA, Hitoshi NISHIDA, Niiti MIYAMOT ...

1994 Volume 54 Issue 6 Pages 351-357
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.351

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A case of hepatocellular carcinoma (HCC) complicating primary biliary cirrhosis (PBC) is reported. In July 1983, a 45-year-old male was found to have liver injury by a routine medical health check. The diagnosis of asymptomatic PBC was made based on findings of elevated serum alkaline phosphatase and IgM, positivity of anti-mitochondrial antibody and no clinical symptoms. The liver biopsy specimen indicated histologically compatible findings of PBC. He was followed up as an outpatient. In January 1991 he was admitted for hematoemesis caused by rupture of the esophageal varices and treated with EIS. In May 1991 elevation of alpha-fetoprotein (27ng/dl) was revealed, but HCC was not detected by abdominal US or by CT. Further, the alpha-fetoprotein level gradually increased. In January 1992 he was readmitted for hematoemesis caused by esophageal varices and EIS was performed again. However, a space occupying lesion (3 cm in diameter) was detected in the right hepatic lobe by abdominal US and CT. A markedly high value of alpha-fetoprotein was detected (3501mg/dl) . Celiac angiography revealed hypervascular lesions in the same area. These morphological examinations indicated hepatocellular carcinoma. Define TEA was performed as the treatment for HCC. The alpha-fetoprotein level decreased significantly after TAE, but his liver function gradually worsened, and he died. A relationship between chronic HCV infection and the development of HCC in PBC is suggested. However, this patient was negative for both HBV and HCV markers.

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[title in Japanese]

[in Japanese]

1994 Volume 54 Issue 6 Pages 360-364
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.360

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[title in Japanese]

[in Japanese]

1994 Volume 54 Issue 6 Pages 364-370
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.364

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[title in Japanese]

[in Japanese]

1994 Volume 54 Issue 6 Pages 370-373
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.370

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[title in Japanese]

[in Japanese]

1994 Volume 54 Issue 6 Pages 373-377
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.373

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[title in Japanese]

1994 Volume 54 Issue 6 Pages 377-379
Published: December 28, 1994
Released on J-STAGE: September 09, 2010

DOIhttps://doi.org/10.14930/jsma1939.54.377

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