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Volume 59, Issue 1
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[in Japanese]1999 Volume 59 Issue 1 Pages 1
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
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[in Japanese]1999 Volume 59 Issue 1 Pages 2-4
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
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[in Japanese]1999 Volume 59 Issue 1 Pages 5-7
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
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[in Japanese], [in Japanese], [in Japanese]1999 Volume 59 Issue 1 Pages 8-11
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
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[in Japanese], [in Japanese], [in Japanese]1999 Volume 59 Issue 1 Pages 12-15
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
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[in Japanese], [in Japanese]1999 Volume 59 Issue 1 Pages 16-21
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
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Masahide TANI, Masahiro INAGAKI, Katsuji OGUCHI, Hidetsugu NAKAYAMA, H ...1999 Volume 59 Issue 1 Pages 22-27
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSIt is important to improve abnormal lipid metabolism of hemodialysis patients to obtain better long-term prognoses. We examined the effects of 18-month low-dose pravastatin treatment (MevalotinTM, 5mg/day), an HMG-Co A reductase inhibitor, on plasma total cholesterol levels (TC) and other lipid-parameters in 13 hemodialysis patients showing moderate hypercholesterolemia. TC was reduced significantly by 18-26% one month after the start of treatment up to the end of the 18-month period in line with the decrease in apoprotein B (Apo B) . Very low density lipoprotein (VLDL) showed a sustained decrease on and after the end of the third month. A significant and sustained decrease in plasma triglyceride was also observed after 1-month treatment. Low density lipoprotein ( LDL), however, decreased until the end of the second month, but increased thereafter; and at the end of the 18th month, LDL significantly increased by about 18 %. This was thought to reflect the breakdown and composition changes of lipoprotein particles, induced by the treatment. The use of low-dose pravastatin seems clinically effective for hemodialysis patients with moderate hypercholesterolemia, but further detailed examination of suspected changes of lipoproteins is necessary.View full abstractDownload PDF (630K) -
Hiroshi SHIMURA, Masahiko YAMAGUCHI, Akihiko MATUMIYA, Masaou KUZUME, ...1999 Volume 59 Issue 1 Pages 28-34
Published: February 28, 1999
Released on J-STAGE: November 19, 2010
JOURNAL FREE ACCESSEndothelial cell (EC) injury induced by reactive oxygen species (ROS) was investigated and the effects of Ca2+ channel blockers, agents which elevate intracellular cAMP levels ( [cAMP] 1), and protein kinase inhibitors on ROS-induced EC injury were analyzed using human umbilical vein EC cultures. Exposure to ROS increased intracellular Ca2+ levels and decreased [cAMP] 1. Ca2+ channel blockers, [cAMP] 1-elevating agents, and protein kinase inhibitors significantly inhibited ROS-induced EC injury. The data suggest that ROS-induced EC injury is mediated by extracellular Ca2+ influx, intracellular cAMP efflux, and intracellular signaling, each of which is blocked by Ca2+ channel blockers, [cAMP] 1-elevating agents, or protein kinase inhibitors. It is suggested that ischemia/reperfusion injury induced by ROS may be prevented by Ca2+ channel blockers, [cAMP] 1-elevating agents, and protein kinase inhibitors.View full abstractDownload PDF (2296K) -
Hiroshi MACHIDA, Akihiko MATSUMIYA, Masahiko YAMAGUCHI, Tadashi MATSUM ...1999 Volume 59 Issue 1 Pages 35-41
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSLeukocyte-vascular endothelial cell (EC) interactions which promote inflammatory and immune reactions involve bidirectional signaling between the two cell types. We investigated the effects of flow on neutrophil-mediated changes in endothelial intracellular Ca2+ levels ( [Ca2+] i) . Cultured human umbilical vein ECs stimulated with endotoxin were labeled with Fura-2 and exposed to fluid flow with neutrophils. Individual changes in [Ca2+] iwere monitored. Application of flow with neutrophils to stimulated ECs led to an increase in [Ca2+] i although neither flow without neutrophils nor neutrophils without flow rarely induced rises in [Ca2+] i. Furthermore, flow application with neutrophils to unstimulated ECs also rarely promoted rises in [Ca2+] i. These findings suggest that flow may contribute to initiation or enhancement of the inflammatory process via induction of Ca2+ signaling in endotoxin-stimulated endothelium facing neutrophils in blood flow.View full abstractDownload PDF (2019K) -
Shoji SASAYA, Hidefumi YAGI, Masahiko YAMAGUCHI, Hiroshi NAKANO, Takem ...1999 Volume 59 Issue 1 Pages 42-47
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSPortal venous flow (PVF) after oral intake of glucose increases less in patients with liver cirrhosis than in normal volunteers. We investigated whether increases in PVF after oral intake of glucose could be used to estimate liver function.
PVF was measured with Doppler ultrasonography after oral intake of 75g glucose in 60 patients; 23 patients had hepatocellular carcinoma and liver cirrhosis (LC), 21 had tumors metastatic to a normal liver (non-LC), and 16 had obstructive jaundice treated with percutaneous transhepatic cholangio drainage (PTCD) .
The ratio of PVF 30 minutes after glucose intake to that before intake (PVFR30) was significantly lower in LC patients than in non-LC patients. PVFR30 correlated significantly with other indices of liver function, involving Child-Pugh score, prothrombin time, and results of the hepaplastin test, indocyanine green clearance test and galactosyl human serum albumin liver scintigraphy. PVFR30 less than 1.5 indicated impaired hepatic function. Decreased levels of total bilirubin in the 1st week after PTCD were significantly lower in patients in whom PVFR30 was less than 1.5, than in patients in whom PVFR30 was more than 1.5.
These results suggest that PVFR30 can be used to estimate liver function and predict outcome after PTCD.View full abstractDownload PDF (670K) -
—Comparison with Measured Values and Values Obtained by Predicted Formulas—Tadashi OKAYASU, Yuhto KUWASAKO1999 Volume 59 Issue 1 Pages 48-65
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSPreoperative pulmonary function tests are useful to obtain the patient's pulmonary condition and detect postoperative pulmonary complications. Usually the preoperative pulmonary functions are evaluated by standard formulas from the Japan Respiratory Society. Compared to patients without any surgery, the patients who are scheduled for surgeries have many factors which cause deterioration of pulmonary functions. In this study we investigated the reliability of the predicted formulas to evaluate the preoperative pulmonary functions. We studied 2594 patients 20 to 94 years of age who had undergone preoperative pulmonary function tests such as spirometory, maximum expiratory flow volume curve, closing volume and blood gas analysis 2-3 days before operations. The patients were divided into 4 groups according to sex and smoking habit. The regression formulas between each parameter (VC/ Ht, FVC / Ht, FEV1.0/Ht, FEV1.0%, FRC/Ht, RV/TLC, PEFR/Ht, V25/Ht, CV/VC, CC/TLC, PaCO2, PaO2) and patient's age were calculated by regression analysis. The regression formulas were compared with the predicted formulas proposed by the Japanese Respiratory Society or Tomita. There were no significant differences of pulmonary function between the smokers and the nonsmokers. When we compared the regression formulas with the predicted formulas, the former formulas were always below for the same age range. In VC/Ht, FVC/Ht, FRC/Ht, FRC/Ht, FEV1.0/Ht, FEV1.0%/Ht, PEFR/Ht, V25/Ht, and PaO2, the incidence of subjects with values less than the standard values was high in all age groups. In particular, incidences of abnormal values of VC/Ht, FVC/Ht, FRC/Ht and FEV1.0/Ht increased with age. The number of patients with neither obstructive lung disease nor restrictive lung disease decreased with age. There were many preoperative patients with pulmonary functions below the standard value levels. We concluded that when we evaluate the preoperative pulmonary function using the predicted formulas, there is a possibility to have an appropriate estimation.View full abstractDownload PDF (1703K) -
—Technetium-99m Diethylenetriamine Pentaacetic Acid-Galactosyl Human Serum Albumin Liver Scintigraphy is Useful for Selecting Candidates for Preoperative—Kozo YOSHIDA, Hiroshi NAKANO, Sei TAKEUCHI, Masahiko YAMAGUCHI, Yasuo ...1999 Volume 59 Issue 1 Pages 66-72
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSSelection of candidates for preoperative hepatic transarterial chemoembolization (TALE) has yet to be clarified by recent studies in patients with hepatocellular carcinoma (HCC) complicated by chronic liver diseases. The aim of the present study was to deteminate which candidates are preferable for preoperative TACE cosidering the hepatic functional reserve of these patients. Technetium-99m diethylenetriamine pentaacetic acid-galactosyl human serum albumin (Tc-GSA) liver scintigraphy is used to assess hepatic functional reserve before and after TALE.
Liver scintigraphy was performed before and a few weeks after TACE in 64 patients with HCC complicated by chronic hepatitis or cirrhosis. The ratio of liver to heart plus liver radioactivity of Tc-GSA 15 minutes after injection, which is expressed as LHL15, was calculated. In addition, conventional hepatic functional tests were also performed. With respect to hepatic functional reserve, an indication of hepatectomy after TACE was determinated based mainly on the previously reported value of LHL15≥0.91. Patients were divided into an LHL15≥0.91 group and an LHL15≥0.91 group according to the LHL15 value measured before TALE.
LHL15 value, liver volume, and prothrombin time after TACE significantly increased more in HCC patients with LHL15<0.91 (n=29) than in those with LHL15≥0.91 (n=35, p<0.001, p<0.05, and p<0.05, respectively) . Nineteen patients with LHL15≥0.91 underwent hepatectomy after TALE. On the other hand, 7 patients with LHL15<0.91 underwent hepatectomy because the LHL15 value increased to more than 0.91 after TALE. There were no major postoperative complications in the patients with LHL15<0.91 undergoing hepatectomy.
The results suggest Regarding hepatic functional reserve the results suggest that HCC patients with LHL15≥0.91 are not candidates for preoperative TALE, and that preoperative TALE is recommended for patients with LHL15<0.91 before TALE.View full abstractDownload PDF (795K) -
DEVELOPMENT OF SIMPLE METHODS FOR EVALUATION OF AMBULATION IN HANDICAPPED ELDERLY AND THEIR EFFICACY—Focus on the correlation with Stepping Balance and Standing-up-by-holding Test—Hiroshi IMAIZUMI1999 Volume 59 Issue 1 Pages 73-86
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSFor people engaged in home or community care, the establishment of efficient evaluation methods for ambulation ability in the handicapped elderly is an important matter which directly links to their ADL or QOL. Therefore, as methods of rough evaluation of balance and muscle power of the lower extremities, I developed a stepping balance test and a standing-up-by-holding test which can be done without any complicated devices.
One hundred and five handicapped elderly who dwelled in nursing homes or in a community were examined with 13 tests including the stepping balance test and the standing-up-by-holding test. Over a one-year period after the tests, ambulation level, independence rate of ambulation and episodes of falls were checked and analyzed for the correlation with the results of the 13 tests.
The stepping balance showed correlation with the functional and the practical ambulation levels (r=0.81, 0.75, respectively) and suggested that a person with balance stage IV or more had a high possibility of walking with a cane or more practical ambulation. The stepping balance also showed correlation with the ability of to go up and down the stairs, and with the transfer level (r=0.73, 0.61, respectively), which meant that the higher the balance stage, the higher the independence rate. Standing for more than 2 seconds on a dominant leg with eyes open was suggested to be correlative with the ambulation level. The standing-up-by-holding height correlated with the ability of going up and down stairs, with the practical ambulation level and with the transfer level (r=0.73, 0.69, 0.64, respectively) . Twenty centimeters was the borderline for practical ambulation instead of walking with a cane, and 10 cm for going up and down the stairs. Fallswere correlative with the stepping balance (r=0.68), and were suggested to be closely linked toa time period, toilet activity and dementia. Among the stepping balance test, the standing-up-by-holding test and the practical ambulation level, there was a high correlation (r=0.88), which implies strong confidence of the tests.
The stepping balance test and the standing-up-by-holding test are simple methods which can bedone by anyone and anywhere, and are useful and adequate measures to estimate the ambulation level and the independence rate of ambulation in the handicapped elderly.View full abstractDownload PDF (1328K) -
Takumi ABE, Kiyoshi MATSUMOTO, Seido OHKI, Harumi SUZAKI1999 Volume 59 Issue 1 Pages 87-91
Published: February 28, 1999
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSDirect transnasal transsphenoidal debulking of pituitary adenomas using endoscopic guidance is presented. The transnasal approach proceeded under an operative microscope. A 4 mm sinonasal rigid endoscope with 0, 30, and 70 degrees angled lenses was used. After complete resection of a section of the intrasellar tumor, an endoscope was introduced as the tool of visualization. Surgical instruments were inserted adjacent to the endoscope through the same nostril. An extrasellar tumor was resected using a micro-pressure-suction-irrigation system under endoscopic guidance. This procedure was used for 9 patients with macroadenoma and 4 with microadenoma. The endoscope, especially with a 70-degree viewing angle, was useful for direct inspection of the eccentric tumor sites, such as the cavernous sinus, the upper part of the planum sphenoidale, or the posterior suprasellar regions. Total tumor resection was achieved in 12 patients except for 2 with extensive cavernous sinus invasion. No complications related to this procedure were encountered for any of patients. Excellent endoscopic visualization provides potential for more complete resection of eccentric tumor sections under direct transnasal pituitary procedures.View full abstractDownload PDF (4211K)
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