The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 42, Issue 3
Displaying 1-6 of 6 articles from this issue
  • Louis Sokoloff
    1993 Volume 42 Issue 3 Pages 95-103
    Published: 1993
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Previous neuroanatomical and electrophysiological methods to localize functional activity in the nervous system focus on perikarya as the sites of the activity. Metabolic mapping of local functional activity in the nervous system provides a new dimension, the activity in the neuropil. Studies of local glucose utilization have shown that energy metabolism is increased by functional activation, but the effects are mainly in the terminal projection zones of the activated pathway. Electrical stimulation of a pathway raises glucose utilization in the projection zones of the pathway in almost direct proportion to the spike frequency. For example, electrical stimulation of the sciatic nerve produces frequency-dependent metabolic activation in the dorsal horn of the lumbar cord, where the axonal terminals of the afferent pathway reside, but no apparent metabolic effects in the cell bodies of the pathway in the dorsal root ganglia. Functional activation of the hypothalamo-hypophysial pathway by salt-loading increases glucose utilization in the pituitary neural lobe, where the terminal axons of the pathway reside, but not in the paraventricular and supraoptic nuclei, the sites of the cell bodies of origin of the pathway. Reflex activation by hypotension of pathways to these nuclei from brain stem structures involved in baroreceptor reflexes, however, increases glucose utilization in these nuclei. Depolarization induced by electrical stimulation, extracellular K+, or opening of Na+ channels with veratridine, stimulates glucose utilization in neural tissues, and this increase is blocked by ouabain, a specific inhibitor of Na+, K+-ATPase. Activation of this enzyme to restore ionic gradients across cellular membranes appears to trigger the functional activation of energy metabolism. The metabolic activation appears, therefore, to be associated not directly with the functional activity but rather with the recovery from the consequences of that activity.
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  • Toyomi Fujino, Hideo Nakajima, Tsuyoshi Kaneko, Masahiro Kobayashi, Ta ...
    1993 Volume 42 Issue 3 Pages 104-114
    Published: 1993
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The concept of simulation surgery was first proposed by Fujino in 19891 and reinforced in 1991.2 It is divided in two sections; empirical simulation surgery, where the surgical procedure is designed first in the surgeon's brain, and computer simulation surgery, where the disease condition and the possible surgical procedures can be viewed in three-dimentions (3D) either on a computer monitor, or by means of a solid 3D model, crafted from computer generated data, before proceeding to the actual surgery itself. Each of these sections is subdivided into three subsections; morphological, functional and psychological simulation surgery, respectively. Along those lines, the concept of simulation surgery is discussed, with special reference to plastic and reconstructive surgery.
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  • Minoru Sugita, Shaw Watanabe, Masao Kanamori, Takashi Izuno
    1993 Volume 42 Issue 3 Pages 115-118
    Published: 1993
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Members of The Japanese Society of Cancer Epidemiology were questioned about relative risk in cancer epidemiology. The notable minimum value of relative risk recognized by the epidemiologists distributed from 1.1 to 5.0, and the mean and the standard deviation of the notable minimum value were 1.92 and 0.760. In civil litigation of United States a plaintiff must prove one's case by a “preponderance of evidence, ” which means that a causal relationship between risk factors and a health disturbance to a plaintiff is proved when relative risk is 2.0 or more. The mean value 1.92 of the notable minimum value of relative risk nearly corresponded to the relative risk 2.0, which indicates that opinion of Japanese epidemiologists did not disagree with the rule of the proof in civil litigation of United States. It is mentioned that the standard of the proof should be “high probability” based on “a high level of conviction in the judge's own mind” in Japanese civil trials, and that the “high probability” means that relative risk is 5.0 or more if we dare to quantify the vagueness. This value corresponded to the maximum value of the notable minimum relative risk in the questionnaire to the Japanese epidemiologists. In civil litigation of Japan, the standard of the proof based on epidemiological results may be more conservative than the opinion of Japanese epidemiologists.
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  • Hiroshi Nakamura, Hiroshi Yoshimatsu, Norikazu Tamaoki, Masaharu Tsuch ...
    1993 Volume 42 Issue 3 Pages 119-121
    Published: 1993
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    We reviewed 17 patients submitted to thymectomy via the suprasternal notch (Yoshimatsu Method I), which was performed before transplantation in 12 patients and after transplantation in 5 patients. There were no complications of thymectomy. Graft survival of our patients with thymectomy was better than that for the overall allograft survival in Japan transplant registry for the same period. Pathologic studies revealed that involution of the cortex was not observed in 5 thymuses removed from recipients who had thymectomy after transplantation even though 2 of them had received 6.4 g and 3.5 g of prednisolone for 19 months and 32 months, respectively.
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  • Hiroshi Nakashima, Kazuyuki Omae, Kazuto Yamazaki, Tohru Sakai, Haruhi ...
    1993 Volume 42 Issue 3 Pages 122-124
    Published: 1993
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The toxicities of silicon tetraalkoxides, including tetramethoxysilane [Si(OCH3)4, TMOS], tetraethoxysilane [Si(OC2H5)4, TEOS], tetrapropoxysilane [Si(OC3H7)4, TPOS] and tetrabuthoxysilane [Si(OC4H9)4, TBOS], were investigated with intraperitoneal injection of 1, 000 mg/kg of each compound. TMOS, as well as TEOS, caused acute tubular necrosis. Blood biochemical examination revealed elevation of blood urea nitrogen and creatinine in mice treated with TEOS, TPOS and TBOS, though TMOS treated mice died and therefore could not be examined. The severity of nephrotoxicity differs among these silicon tetraalkoxides. The spleens of mice treated with TMOS exhibited cytolysis in the white and red pulp, suggesting direct injury to the spleen. The kidney seems to be a common target, organ of silicon tetraalkoxides.
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  • 1993 Volume 42 Issue 3 Pages e1
    Published: 1993
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
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