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Volume 42, Issue 1
Displaying 1-6 of 6 articles from this issue
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Robert R Wolfe1993 Volume 42 Issue 1 Pages 1-8
Published: 1993
Released on J-STAGE: March 27, 2009
JOURNAL FREE ACCESSThe response to critical illness involves alterations in all aspects of metabolic control, favoring catabolism of stored energy substrates and protein. Glucose production is accelerated, due principally to a chronic elevation in glucagon. Whereas glucose is available at increased rates, the muscle tissue is less responsive than normal to the stimulatory effect of insulin on glucose uptake. Stored triglyceride is also catabolized at a high rate, predominately due to enhanced adrenergic activity. This causes the release of free fatty acids at a rate well in excess of their requirement for oxidation, leading to a high rate of reesterification and triglyceride transport in plasma. Protein metabolism is characterized by accelerated catabolism that is not balanced by a corresponding increase in synthesis. Whereas the mechanism for this response is not known, peripheral insulin resistance does not appear to be responsible.View full abstractDownload PDF (725K) -
Tetsuo Kato, Hiroaki Yoshino, Takatsugu Murakoshi, Tatsuzo Hebiguchi, ...1993 Volume 42 Issue 1 Pages 9-13
Published: 1993
Released on J-STAGE: March 27, 2009
JOURNAL FREE ACCESSTo study the mechanism of the intrahepatic cholestasis observed during total parenteral nutrition (TPN) in neonates, we examined the localization of IgA, secretory component (SC) and complement component C3 (C3) in the liver in 4 patients by light and electron microscopic immunohisto chemistry. In the patients who received TPN for 1 month, IgA and SC positive cholestasis was limited to bile canaliculi, but the integrity of both the canalicular wall and intercellular tight junction was maintained. These findings suggest that obstruction in the biliary tract develops at the canalis of Hering, causing reflux of IgA and SC into the bile canaliculi. When the duration of TPN extended beyond 6 months, the cholestasis in bile canaliculi progressed further, and degeneration of hepatocytes became more marked. Bile retained in hepatocytes occasionally contained IgA and SC. IgA and SC-positive cholestasis also developed in the interlobular bile ducts, where no cholestasis had been observed 1 month after the beginning of TPN. SC production and SC-mediated transport of IgA, which are important functions of bile duct epithelial cells in the local immune mechanism, were impaired in association with the injury of those cells. C3 was localized not only in the hepatocellular organelles where C3 is normally observed, but also in the lumen of dilated bile canaliculi, suggesting that C3 is released from hepatocytes into bile in neonates receiving TPN and that C3 may be involved in some local immune mechanism of biliary system.View full abstractDownload PDF (7146K) -
Hisao Ogata, Takashi Fukutomi1993 Volume 42 Issue 1 Pages 14-17
Published: 1993
Released on J-STAGE: March 27, 2009
JOURNAL FREE ACCESSThe problems of assessment of response to therapy and the factors contributing to the postrecurrence survival period were clinically investigated using 72 patients mostly with evaluable bone metastases. When the various factors involved in the post-recurrence survival period were investigated by Cox multivariate analysis, the results were significant for number of metastatic lymph nodes at initial surgery (p<0.05) and disease-free period (p<0.01), while the therapeutic effect on bone metastases made only a marginal contribution (p=0.06). Imaging of bone metastases required a long time until effects could be assessed, 4 months (1-20 months) for Partial Response (PR) cases and 10 months (2-60 months) for Progressive Disease (PD) cases, with a median of 8 months, but even so, assessment of effect based on imaging techniques did not necessarily correlate with the clinical course. No background factors or therapeutic modalities typical for responders were noted. These findings require a comprehensive assessment of therapeutic utility for bone metastases by considering (a) the improvement of clinical symptoms (b) the decrease in tumor markers, and (c) the absence of new lesions.View full abstractDownload PDF (333K) -
Yoshio Izumi, Yasuo Fukuuchi, Takashi Hata, Akira Imai, Kazuo Isozumi1993 Volume 42 Issue 1 Pages 18-21
Published: 1993
Released on J-STAGE: March 27, 2009
JOURNAL FREE ACCESSThe present study examined the changes of cerebrovascular CO2 reactivity during insulin-induced hypoglycemia and in the recovery period following glucose administration in cats. The diameters of pial vessels were continuously measured using the vidicon camera system. Hypoglycemia was induced by intraperitoneal injection of ActrapidR insulin (100IU/kg). Cerebrovascular CO2 reactivity was estimated by the changes of pial vessel diameters during 3 min inhalation of 5% CO2 in air at each stage of glucose level. CO2 reactivity was impaired in the hypoglycemic stage and this impairment was further enhanced in the early recovery stage. In the late recovery stage, CO2 reactivity was restored particularly in the small arteries which were less innervated by autonomic nerves. These results suggest that the sympathetic activity plays an important role in the impairment of cerebrovascular CO2 reactivity during hypoglycemia.View full abstractDownload PDF (298K) -
Tsuyoshi Kaneko1993 Volume 42 Issue 1 Pages 22-40
Published: 1993
Released on J-STAGE: March 27, 2009
JOURNAL FREE ACCESSMicrotia is one form of ear anomalies representing the defect of a partial or total loss of external ear. This paper describes new method of total auricular reconstruction which combines the use of tissue expander and the non-contact, 3-dimensional (3-D) shape measurement system. The anterolateral and posterior surface of the both sides of the ear of the patients were measured with the 3-D shape measure ment system. The data from normal side was mirror-imaged electronicJliy and transferred to the computer-controlled milling machine to create the life-sized, mirror-image wax model. These models were sterialized and used as a template or an aid during assembling procedure of the autologous cartilage frame work in order to reproduce the 3-D configuration of the wax model. Seven cases were treated with this method and 5 cases (72%) were graded as excellent (superior to that result obtainable from conventional methodology), one each (14%) was good (better result) and fair (the same level). There are no poor evaluations. In two cases, the exposure of the expander, one of the major complications, developed. Although additional surgery was needed, excellent and fair result was obtained in these cases. It was concluded that the method presented here was evaluated as an overall good method and its application should be further extended.View full abstractDownload PDF (20024K) -
Shohken Chin, Shigehiro Kikuyama, Toshio Hashimoto, Tohji Tomita, Tosh ...1993 Volume 42 Issue 1 Pages 41-43
Published: 1993
Released on J-STAGE: March 27, 2009
JOURNAL FREE ACCESSA rare case of lymphangioma of the jejunal mesentery in a 34-year-old woman is presented. She was diagnosed as having an ovarian cyst preoperatively, but laparotomy revealed a cystic tumor of the mesentery that was histologically diagnosed as lymphangioma. Thus far, 44 cases of adult mesenteric lymphangioma have been reported in Japan. In nine cases, accurate diagnosis of mesenteric cysts was obtained preoperatively. In 31 cases, complete excision with or without bowel resection was done, whereas two cases were partially resected and one case was drained.View full abstractDownload PDF (2882K)
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