The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 37, Issue 1
Displaying 1-7 of 7 articles from this issue
  • Nobutake Matsuo
    1988 Volume 37 Issue 1 Pages 1-9
    Published: 1988
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The phenylalanine hydroxylating system and its related disorders have been intensely investigated during the past decade. This article discusses on some of the newer developments in the study of the physiology and pathophysiology of human phenylalanine metabolism: 1) the phenylalanine hydroxylating system, 2) the early diagnosis of hyperphenylalaninemia syndromes, 3) the molecular basis for phenotypic heterogeneity of phenylketonuria, 4) the prenatal diagnosis of phenylketonuria, and 5) hyperphenylalaninemia caused by defects in tetrahydrobiopterin metabolism.
    Download PDF (449K)
  • Charles B. Brendler
    1988 Volume 37 Issue 1 Pages 10-23
    Published: 1988
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    This paper reviews current concepts and recent advances in the diagnosis and staging of carcinoma of the prostate (CaP). Open perineal biopsy is seldom performed because of unnecessary morbidity and a substantial risk of impotence. Transurethral biopsy is inaccurate in detecting both early CaP and residual Cap following transurethral resection of the prostate. Transrectal needle biopsy is contraindicated because of a high rate of sepsis. Transperineal needle biopsy is accurate, has a low risk of complications, and can be performed in an out-patient setting. Transrectal needle aspiration of the prostate appears very accurate with even less morbidity and may replace core needle biopsy in the future. The staging of CaP includes measurement of prostatic acid phosphatase (PAP), radionuclide bone scan, and pelvic lymphadenectomy. PAP should be measured enzymatically using thymolphthalein monophosphate as the substrate. Patients with elevated serum levels of PAP (0.8 IU/L) generally have advanced disease and are not candidates for radical prostatectomy. Radioimmunoassay measurements of PAP have not proved useful because of low specificity. Prostate specific-antigen (PSA) levels are similar in CaP and BPH, and PSA does not appear useful in either the diagnosis or staging of CaP. PSA is, however, extremely sensitive in detecting residual disease after radical prostatectomy. Alkaline phosphate and other biochemical markers have not been reliable because of low specificity. Flow cytometry is a new technique that may be useful in selecting patients for radical prostatectomy. The value of transrectal ultrasound both in diagnosis and staging remains uncertain. Radionuclide bone scan is extremely accurate in detecting osseous metastasis with a false negative rate of two percent. Pelvic lymphadenectomy with frozen section diagnosis is highly accurate in detecting lymphnode metastases with a false negative rate of three point five percent.
    Download PDF (686K)
  • Kiyoshi Matsuda, Tetsuo Kato, Tatsuzo Hebiguchi, Kenji Koyama, Masahir ...
    1988 Volume 37 Issue 1 Pages 24-36
    Published: 1988
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Diaphragmatic hernia was experimentally produced in fetal rabbits from the 21st to 25th gestational day by rupturing the left diaphragm in utero. The pulmonary vascular system of 18 out of 48 fetuses successfully recovered was examined. Radius and thickness of the media of the pulmonary artery were measured using Suwa's histometrical techniques. Total length of the acinar arteries and capillaries were measured by a stereological method. The radius of the pulmonary acinar arteries in the experimental models was smaller than normal. The proportion of the thickness of the media to the radius increased significantly in the models, and the total length of the acinar arteries as well as capillaries was remarkably reduced in the models. These findings were all in the bilateral lungs. These results suggest that pulmonary vascular disorders caused by diaphragmatic hernia in fetal life result in absolute reduction of total pulmonary vascular capacity.
    Download PDF (1619K)
  • Masashi Taki
    1988 Volume 37 Issue 1 Pages 37-53
    Published: 1988
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The structure of platelet glycoprotein Ib (GP Ib) and its functional domain for human von Willebrand factor (vWF) were investigated using an elastase-like proteinase (ELP) purified from human granulocytes and a monoclonal antibody (56-2) against GP Ib which completely inhibited the interaction of platelets with human vWF. Treatment of platelets with ELP resulted in loss of their ability to interact with human vWF in the presence of ristocetin. A fluorogram of SDS-PAGE of 3H-labelled platelets treated with ELP revealed that a band corresponding to GP Ib was clearly decreased and fragments with molecular weights (MW) of 97 kilo-daltons (KD), 70 KD, 60, KD, 47 KD, 44 KD, 37 KD, 25 KD and 15 KD were released from the platelets. The 47 KD fragment was initially cleaved from the platelets, and the 25 KD fragment showed a much fainter band when compared with the 47 KD and 44 KD fragments. Similar results were obtained when partially purified GP Ib was digested by ELP. When these fragments were reacted with 56-2 antibody, the fragments with MW of 47 KD, 44 KD and 25 KD were immunoisolated. The electrophoretic mobility of these three bands was slightly slow under reduced conditions compared with the results obtained under non-reduced conditions. The fragment of MW 25 KD should be derived from the fragments with MW of 47 KD and 44 KD, since these three fragments have an epitope to 56-2 antibody. The results obtained suggest that the functional domain of GP Ib for human vWF binding may be located in a less glycosylated fragment of MW 25 KD on the distal portion of GP Ib, which should contain loop region with at least one intramolecular disulfide bond, and this region may be important for the interaction of platelets with human vWF.
    Download PDF (2322K)
  • Kunihiko Sato
    1988 Volume 37 Issue 1 Pages 54-71
    Published: 1988
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Plasma von Willebrand factor (vWF) in eleven patients with essential thrombocythemia was studied quantitatively and qualitatively to assess its role in the development of bleeding tendency. Five patients with prolonged bleeding time including three with clinical bleeding tendencies showed decreased ristocetin cofactor (VIIIR:RCo) and factor VIII-related antigen (VIIIR:Ag). On the other hand, six patients without prolongation of bleeding time had normal VIIIR:RCo and VIIIR:Ag. Analysis of vWF multimeric structures by SDSagarose gel electrophoresis revealed lack of the lager multimers in the former group of patients. These abnormalities of plasma vWF were corrected when platelet counts became nearly normal by treatment with busulfan. Infusion of 1-diamino-S-Arginin-Vasopressin improved all the hemostatic abnormalities except for defective platelet aggregation seen in patients with essential thrombocythemia. These results indicate that qualitative and quantitative abnormality of vWF is the main causative factor in development of bleeding tendency in patients with essential thrombocythemia.
    Download PDF (2229K)
  • Jun Nakashima
    1988 Volume 37 Issue 1 Pages 72-84
    Published: 1988
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Tumor necrosis factor (TNF) has attracted much attention because of its unique biological characteristics such as oncolytic capabilities, a lack of species specificity, and the ability to discriminate between normal and certain tumor cells in vitro. This study was made to determine in vitro induction of endogenous TNF and its cytotoxicity against renal cell carcinoma cells, KU2 and Caki 1. Endogenous TNF titers were assayed by cytotoxicity against L929 using anti-TNF antibodies. Endogenous TNF induced by in vitro culture of PBL with OK432 showed cytotoxicity against KU2 and Caki 1. The high level of TNF activity in the supernatant from PBL cultured with OK432 was noted at 12 hr of incubation and when the concentration of OK432 was adjusted to 0.05 KE/ml. Augmented production of TNF was observed at 48 and 72 hr of incubation when PBL were cultured with OK432 of 0.05 KE/ml and colony stimulating factor (CSF) of 100 units/ml. Based on the result that TNF can be produced by activated PBL with biological response modifiers (BRMs), TNF can be expected to play an integral role in complicated antitumor mechanisms brought about in a patient receiving BRMs. For the treatment of patients with advanced renal cell carcinoma, effective therapy through augmenting TNF activity should be taken into consideration.
    Download PDF (514K)
  • Christer Owman
    1988 Volume 37 Issue 1 Pages 85-95
    Published: 1988
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Immunohistochemical and pharmacological studies have been performed on rat, guinea-pig, and monkey in order to elucidate serotonergic mechanisms in the cerebrovascular bed. The results provide strong evidence that 5-hydroxytryptamine is present together with noradrenaline in perivascular sympathetic nerves, which also contain neuropeptide Y. Sympathetic nerve activation induces a co-release of 5-hydroxytryptamine, which markedly potentiates the vasoconstrictor action of noradrenaline via specific serotonergic receptors. These receptors are of the same kind as those mediating the postjunctional contractile effect of 5-hydroxytryptamine. This observation of a new type of amine transmitter coexistence in sympathetic nerve fibres may help to understand the powerful vasoconstrictory potency of 5-hydroxytryptamine in the brain vasculature, and thereby increase our knowledge about the pathophysiological role of this amine in serious clinical disorders, such as migraine, stroke, and vasospasm following subarachnoid hemorrhage.
    Download PDF (1148K)
feedback
Top