The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 39, Issue 4
Displaying 1-8 of 8 articles from this issue
  • Ossama Al-Mefty, Robert R. Smith
    1990 Volume 39 Issue 4 Pages 217-224
    Published: 1990
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The various modifications and variations of the cranio-orbital approach have been recently described; the author uses different modifications according to the location, size and extent of the lesion. Some of the prime indications for these modifications are presented herein.
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  • C. Venkata S. Ram
    1990 Volume 39 Issue 4 Pages 225-236
    Published: 1990
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Hypertensive crises constitute a group of distinct clinico-pathological entities in which rapid control of hypertension is indicated to previous serious complications. Although systemic blood pressure is invariably elevated in these conditions, it is the status of the target organ function which determines the need for urgent reduction of blood pressure. The physicians should be cognizant of the pathophysiological basis of hypertensive crises so that rational therapeutic choices can be made. The chief objective should be to arrest and, if possible, to reverse the target organ damage. Once the diagnosis of hypertensive crisis is evident, the blood pressure should be lowered quickly while paying careful attention to the cardiovascular, neurologic, and renal function. Several potent, parentally effective antihypertensive drugs such as nitroprusside, labetalol, and nicardipine are available to produce an immediate fall in blood pressure. The choice of drug therapy should be made on the basis of the pharmacodynamic and clinical effects, advantages, and disadvantages. Once the emergency situation is resolved, the etiology of hypertensive crisis should be considered.
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  • Winston W. Shen
    1990 Volume 39 Issue 4 Pages 237-241
    Published: 1990
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    This paper is a brief review which deals with research findings, clinical issues, and strategies in the pharmacotherapy of clinical depression. The author introduces antidepressants which are currently available in the United States. They include heterocyclic antidepressants (tricyclic antidepressants and second-generation antidepressants), monoamine oxidase inhibitors, lithium, carbamazepine, and others. Under the description of each drug category, therapeutic and side effects are briefly discussed in the context of psychiatric practice in America. Then, the author gives a birds eye view of American pharmacotherapy of using antidepressants in acute, maintenance, and prophylactic treatments of depression.
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  • Sukeo Sugimoto, Minoru Fukushima, Takehiko Yazaki, Yutaka Nagata, Jun ...
    1990 Volume 39 Issue 4 Pages 242-246
    Published: 1990
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Periodical checkups on 206 infants were carried out in order to elucidate which of various factors would pose decisive influence upon the retardation of mental development after birth with the AIKEN method. Correlations between average DQ (development quotient) and figures of physical measurements at birth were sought after. Consequently, weeks of gestation, body weight, cephalic circumference and body length at birth revealed certain correlation with the retardation of mental development. Multiple regression analysis disclosed highly significant correlations of body length and cephalic circumference toward the birth weight. Therefore, both weeks of gestation and birth weight are the direct contributory factors to average development quotient. Based on this result, a prediction equation for the mental development after birth has been proposed. Low average DQ was found in high percentages among infants born with toxemia of pregnancy or premature rupture of membranes. However, it is suggested that they are not the direct causes of such retardation, but are rather provoking short weeks of gestation and low birth weight. In summary, the newborn with less than 37 weeks of gestation and below 2, 000 grams of birth weight would be named and classified as a SFD (small for dates) with the problem for mental development (MD-SFD).
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  • Tadashi Murase
    1990 Volume 39 Issue 4 Pages 247-253
    Published: 1990
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Conditioned media (KM-102CM and KM-103CM) obtained from two different human bone marrow stromal cell lines (KM-102 and KM-103) were analysed for their ability to stimulate human hematopoietic stem cells. Both KM-102CM and KM-103CM stimulate the formation of granulocyte-monocyte colony forming unit (CFU-C) and erythroid burst forming unit (BFU-E) colonies in the presence of erythropoietin, and also maintain the long term proliferation of stem cells in vitro. When KM-102CM and KM-103CM were fractionated by DEAE-cellulose chromatography and treated with antiserum against granulocyte-monocyte colony stimulating factor (GM-CSF) these colony stimulating activity (CSA) and burst promoting activity (BPA) contained in these media were neutralized by the antiserum and thus proved to be basically identical to GM-CSF. These results showed that the GM-CSF produced by the marrow stromal cells can maintain and proliferate the hematopoietic progenitor cells in the long term and thus gave us an evidence of one of the regulatory functions of the marrow stromal cells in hematopoietis.
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  • Takashi Ohigashi
    1990 Volume 39 Issue 4 Pages 254-260
    Published: 1990
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    It is possible that a strategy designed to stimulate cancer cells in the active cell cycle may increase the effectiveness of S-phase specific anti-cancer agents such as methotrexate. In this study, the effects of granulocyte-colony stimulating factor (G-CSF) on the proliferation of cultured human bladder cancer cells and on the cytotoxicity of anti-cancer drugs to bladder cancer cells were studied in vitro. The 3H-thymidine uptake of cultured human bladder cancer cells, KU-1 and NBT-2, was significantly higher when the cells were treated with 10 ng/ml G-CSF than without G-CSF after 24- and 48-hour incubation. However, the cell numbers of KU-1 and NBT-2 were not significantly affected by 72-hour treatment with 10 ng/ml G-CSF. The binding of 125I-labeled KW-2228, a muteins of G-CSF, to KU-1 and NBT-2 was inhibited by unlabeled KW-2228 in a concentration dependent manner, which demonstrated the presence of G-CSF receptors on both cells. Scatchard analysis showed that the receptor densities of KU-1 and NBT-2 were 1770 and 3070 per cell, respectively. The combination treatment with methotrexate and G-CSF resulted in a significant increase in cytotoxic effects, when compared with methotrexate treatment alone. This study supports the possibility that the combination therapy of methotrexate and G-CSF increases clinical response in the treatment of advanced bladder cancer.
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  • Michie Hisada, Shinichiro Okamoto, Hideaki Nakajima, Shigeru Nogawa, Y ...
    1990 Volume 39 Issue 4 Pages 261-264
    Published: 1990
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    We report a 69 year-old female with sarcoidosis who developed chronic thrombocytopenia, a rare complication of this disorder. Histologically normal bone marrow with increased number of megakaryocytes and high level of PAIgG strongly suggest the immune destruction of platelets as the cause of thrombocytopenia. In addition to thrombocytopenia, this case is also distinctive in its clinical manifestation. The patient developed several infrequent manifestations of sarcoidosis including complete AV block, uveitis, skin eruptions and middle lobe syndrome, but, did not have an intrathoracic adenopathy, the commonest manifestation of this disease.
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  • Dalmas A. R. Dominicus, Takashi Akamatsu
    1990 Volume 39 Issue 4 Pages 265-269
    Published: 1990
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    In trying to demonstrate the importance of preventive medicine in health care promotion, previous studies involving prevention and control of diseases have been discussed. Preventive medicine is also urged as the best method to help promoting health especially in the developing countries. Developed countries are urged to support developing countries, materially and financially in promoting their health. In terms of cost analysis prevention is an investment in health that produce a reduced probability of mortality and/or morbidity, therefore, we, investors in the developing countries, have to sacrifice something today in order to gain a benefit at a later point in time.
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