The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 41, Issue 2
Displaying 1-6 of 6 articles from this issue
  • Mathias Bartels
    1992 Volume 41 Issue 2 Pages 59-63
    Published: 1992
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The practice of pharmacotherapy of schizophrenia in Germany is basedboth on clinical experience and research findings. Experience and studies emphasize that neuroleptic medication is severely limited by side effects including acute extrapyramidal syndromes and tardive dyskinesia. Comparing neuroleptic dosesin both acute and maintenance therapy have clinicians encouraged to evaluate methods for treating patients with the lowest effective dose. Other studies have shown that the plasma level may be helpful when deciding which is the best treatment for the illness. More precise results for determining the optimum dose of antipsychotic compounds in the future may be available from positron emission tomography (PET), and from fluorine-magnetic-resonance spectroscopy (FMRS). The management of patients whose illness are refractory to conventional neuroleptics is also discussed. Benzamides and clozapine, both atypical neuroleptics, may be moreeffective than other available compounds for the severely ill, or for patients who are unable to tolerate the neurological side effects of typical neuroleptics.
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  • Tsutomu Nakada
    1992 Volume 41 Issue 2 Pages 64-67
    Published: 1992
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Intracellular kinetics of high energy phosphate (HEP) is of fundamental importance in cellular biochemical physiology. In mammalian brain, intracellular HEP transport from the production site (mitochondria) to the consumption site (plasma membrane) is dependent on passive diffusion of HEP through the cytosol. Diffusivity of a substrate in a solution correlates inversely to the viscosity of the solution. The maturational process of mammalian brain involves dramaticchanges in the cytosolic amino acid profile. Since the viscosity of a solution is a function of the diffusion coefficients of solutes and their concentrations, changes in the cytosolic amino acid composition should result in significant alteration in cytosol viscosity and hence, HEP dffusivity. Such a system is especially suitable for mathematical modeling and correlative analysis by in vivo nuclear magnetic resonance (NMR) spectroscopy. This brief review is written to provide a fundamental background for investigational methodologies on developmental neurobiology of cellular energetics.
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  • Frank J Gonzalez
    1992 Volume 41 Issue 2 Pages 68-75
    Published: 1992
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Cytochromes P450 (P450) collectively refer to a superfamily of heme-containing enzymes that use O2 and electrons from NADPH to insert a single atom of oxygen into any one of a large number of substrates. Two general classes of P450s exist; a relatively limited number of P450 forms, expressed in specialized tissues that are associated with pathways of steroidogenesis and a large number of forms responsible for metabolism of foreign compounds. Most of the latter P450s are expressed in liver, the primary site for metabolism of drugs, unusual dietary compounds and environmental pollutants. Numerous forms of P450 are expressed in liver of untreated animals and these are regulated quite dif-ferently. Both developmentally-programmed and sex-specific expressions have been observed. In this review, I will summarize recent findings on the mechanisms by which two P450genes are regulated in livers of developing rats. The CYP2E1 gene is transcriptionally activated within a few hours after birth while the CYP2C6 gene is activated just prior to rats reaching puberty. These genes are under control of two transcription factors, HNF-1 α and DBP, respectively, that themselves are developmentally controlled.
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  • Helmut Bertalanffy, Shinji Mitani, Mitsuhiro Otani, Kiyoshi Ichikizaki ...
    1992 Volume 41 Issue 2 Pages 76-79
    Published: 1992
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Hemilaminectomy is a limited, unilateral approach to the spinal cordthat provides excellent exposure of the dorsolateral and ventral portions of thespinal canal. This approach is most suitable for microsurgical management of themajority of extramedullary tumors. Contrary to conventional laminec-tomy, the posterior supporting structures of the spine are completely preserved on the contralateral side with this access route. The procedure has been applied in 3 patients who harbored a cervical neurilemmoma, a cervical lipoma, and a thoracic neurilemmoma, respectively. Optimal exposure of the lesion was achieved in each case, and each patient's symptoms improved or completely resolved postoperatively. There were no surgical complications. It is concluded that hemilaminectomy combinedwith microsurgical techniques should be given priority over standard laminectomyin the surgical management of extramedullary lesions arising in the spinal canal.
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  • Shiro Saito
    1992 Volume 41 Issue 2 Pages 80-86
    Published: 1992
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    It has been reported that the H-ras gene is activated as oncogene in human bladder cancer cases, and that codon 12 and codon 61 are the major “hot spots” of its activation. A simple method to detect point mutations in these codons of H-ras gene was established for the use of clinical diagnosis. In this method, the DNA segments including codon 12 or codon 61 were amplified by polymerase chain reaction (PCR), and the reaction products were examined for their susceptibility to the restriction enzyme NaeI or BstNI, and by dot blot hybridization assay with oligonucleotide probes. Point mutations were detectable in small amounts of DNAs isolated from fresh or frozen tumor tissues, urine cells and paraffin sections. The method was applied for a clinical sample and a case that had a potint mutation at codon 12 of H-ras gene was detected. The point mutation was existed in DNAs of primary tumor tissue, all recurrent tumor tissues and cells isolated from urine of this case.
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  • Masaru Mimura
    1992 Volume 41 Issue 2 Pages 87-98
    Published: 1992
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Deficits of problem-solving ability in focal brain-damaged patients, with special reference to frontal lobe dysfunction, were investigated by two neuropsychological tests: Temporal rule induction test and Hypothesis-testing measure. Subjects consisted of 84 chronic brain-damaged patients (31 with anterior cerebral lesions and 53 with posterior lesions). The study's aim was to investigate the effects of frontal lobe damage on two aspects of inductive reasoning, prediction and hypothesis behavior. When prediction was examined by Temporal rule induction test, patients with anterior lesions showed deficits in predicting a rule, even in the memory-aid condition in which memory factors were excluded. The poor results on Temporal rule induction test in frontal patients did not appear to be related to deficits in temporal integration, which is generally interpretedas frontal dysfunction. Rule induction may be impaired by frontal damage whenever complicated information-processing is required, even when temporal succession is not involved. Second, two stages of hypothesis behavior, hypothesis-formationand hypothesis-testing, were evaluated. Patients with anterior lesions showed impairment in hypothesis-formation. Their decreased fluency in hypothesis production affected the hypothesis-testing process. However, frontal patients committed fewer errors, most of which were perseverative (lose-stay errors) on hypothesis-testing. Patients with posterior lesions revealed other characteristic errors, such as inconsistent responses and divergent-type errors (improper lose-shift errors). The hemispheric site of the lesion affected only the ability to maintain a hypothesis (win-shift errors). The results illustrated the differences in problem-solving deficits in these two groups of patients. Disturbed prediction of future events, decreased hypothesis fluency, and abnormal lose-stay behavior in patients with frontal lobe damage may be crucial factors in coping with daily problem-solving situations.
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