All issues
Successor
Volume 44 (1994)
- Issue 6 Pages 609-
- Issue 5 Pages 463-
- Issue 4 Pages 317-
- Issue 3 Pages 181-
- Issue 2 Pages 81-
- Issue 1 Pages 1-
Volume 44, Issue 3
Displaying 1-14 of 14 articles from this issue
- |<
- <
- 1
- >
- >|
-
HITOSHI KURABAYASHI1994 Volume 44 Issue 3 Pages 181-192
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSUltrastructural analysis of tumor cells was performed in 44 patients with multiple myeloma in relation to the clinical feature, drug response and prognosis. According to the maturity of nucleus, the myeloma cells were classified into mature, intermediate and immature types. The response to chemotherapy was the worst in patients having myeloma cells with immature nucleus. In contrast, there was no relationship between the maturity of cytoplasm of myeloma cells and drug response. While various nuclear and cytoplasmic abnormalities were observed, the presence of disarrangement of organelles, single sac loop-like structures and numerous intramitochondrial granules was related to poorer response to chemotherapy. Furthermore, it was shown that the more abnormalities were recognized, the shorter the survival was. In addition, there were observed many myeloma cells with immature cytoplasm and cytoplasmic buddings in patients with renal failure. Thus, the study described in this paper suggests that ultrastructural examinations of myeloma cells may give us useful information for the treatment of patients with the disease.View full abstractDownload PDF (3376K) -
TOMOYUKI YOKOYAMA1994 Volume 44 Issue 3 Pages 193-201
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSTo determine whether tumor necrosis factor-α (TNFα) has a negative inotropic effect on the adult heart, the effects of TNFα on the left ventricle and isolated adult cardiocytes were investigated. Studies in the Langendorff heart and isolated adult cardiac myocytes showed that TNFα has a concentration-and time-dependent negative inotropic effect, and that this effect is fully reversible after the removal of TNFα. The time to the onset of the TNFα-induced negative inotropic effects was 15-20 min, and the TNFα concentration was found to be 90-100 U/ml in the Langendorff heart and the isolated cardiac myocytes. Treatment with neutralizing anti-TNFα antibody prevented the negative inotropic effect of TNFα in isolated myocytes. The present results of the study indicate that TNFα has a direct negative inotropic effect on both the intact heart and adult cardiac myocytes.View full abstractDownload PDF (1467K) -
ELECTRON MICROSCOPIC AND ENDOCRINOLOGICAL STUDIESNAOKI OHTA1994 Volume 44 Issue 3 Pages 203-217
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSTransient hypertrophic cardiomyopathy in human infants born of diabetic mothers is well known. In order to elucidate the pathogenesis of this unique type of myocardial disease, morphological and endocrinological studies were performed on fetuses and infants of streptozotocin-induced diabetic rats in the present study.
Disproportionate ventricular septal thickening (DVST) was observed in 76% of the fetuses of diabetic mothers (FDM) on day 21 of gestation and in 60% of 2-day-old infants born of diabetic mothers (IDM). Although DVST was a usual finding in fetuses on day 18 of gestation or before, it was infrequent in control fetuses on day 21 of gestation. Immature side-to-side or side-to-end type intercellular connections were more frequently seen in the ventricular cardiac muscles of FDM on day 21 of gestation and in 2-day-old IDM than in the controls. Serum insulin-like growth factor I (IGF-I) and insulin levels and pancreatic insulin content were significantly lower in FDM and IDM than in the controls, and significant negative correlations were found between serum IGF-I and insulin levels and interventricular septal to left ventricular free wall thickness ratios.
The above findings indicate that DVST in FDM and IDM represents immaturity of cardiac architecture. It is also quite conceivable that insufficient secretion of IGF-I and insulin play significant roles in this immaturity.View full abstractDownload PDF (4380K) -
ETSUO YAMAGUCHI1994 Volume 44 Issue 3 Pages 219-227
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSThe rate-responsive pacing has been reported to improve a physical work capacity. To determine the optimal rate during exercise, a exercise capacity was compared at three pacing rates : fixed-rate ventricular pacing (VVI) at 60 bpm and ventricular rate-responsive pacing (VVIR) at lower and higher rates. The VVIR mode was programmed to attain the heart rates of about 110 bpm (VVIR 110) and 130 bpm (VVIR 130), at the end of exercise. The symptom-limited exercise test was performed at the three pacing rates, using our treadmill protocol in which the work-rate continuously increased every 30 seconds. Oxygen uptake (VO2), carbon dioxide production (VCO2) and other parameters were measured on the breath-by-breath basis. Cardiac output (CO) was measured by the continuous-wave doppler method.
Peak VO2 and anaerobic threshold (ATge) were significantly larger in the VVIR mode than in the VVI mode. Peak VO2 and ATge in VVIR 110 were greater than those in VVIR 130. At peak exercise, cardiac index was significantly larger in the VVIR mode than in the VVI mode. However, there was no significant difference between VVIR 110 and VVIR 130. Thus, although VVIR pacing increases exercise tolerance due to positive chronotropic response, the higher pacing rate dose not necessarily improve exercise capacity. The present study suggests that VVIR 110 is superior to VVIR 130 to obtain greater exercise capacity.View full abstractDownload PDF (1266K) -
YASUHIKO YAMAUCHI1994 Volume 44 Issue 3 Pages 229-237
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSLong-term prognosis was evaluated in 416 myocardial infarction (MI) patients, 339 males and 77 females, admitted to our department between November, 1979 and April, 1992. Twenty patients died in the hospital, 75 died after discharge, 61 required percutaneous transluminal coronary angioplasty or aortocoronary bypass graft, and 4 were lost to follow-up. The cause of death after discharge was reinfarction in 15 patients, heart failure or sudden death in 27 and non-cardiac in 33. Non-survivors were older than survivors, and left ventricular end-diastolic dimension was greater, coronary lesions were more severe and a history of reinfarction was more common in the non-survivors. Among the survivors, serum total and LDL cholesterol levels were higher and coronary lesions were more severe in patients whose condition became worse. Quality of life was most significantly affected by the presence of chest pain. The five-year survival after discharge was 82.5% overall, 90.4% in zero or single vessel disease and 84.3% in multivessel disease.View full abstractDownload PDF (1363K) -
NOBUHIRO OHSHIMA1994 Volume 44 Issue 3 Pages 239-249
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSIn the present study, the author characterized Ca2+ entry pathways in cultured rat aortic smooth muscle cells (SMCs) by measuring the influx of extracellularly added 45Ca2+ or Mn2+ and by measuring the extracellular Ca2+-induced increase in [Ca2+] i under conditions in which removal of cytosolic Ca2+ was inhibited. Ca2+ influx into resting SMCs was inhibited by DHP Ca2+ antagonist PN200-110 and hyperpolarization, and was activated by the DHP Ca2+ agonist BayK8644. Endothelin-1 and PMA suppressed Ca2+-channel activity. The suppressing effects of Endothelin-1 and PMA disappeared when the cells were pretreated with staurosporine, an inhibitor of C kinase. These findings indicate that activation of C kinase causes sustained inhibition of Ca2+-channel activity. DHP-insensitive Ca2+-and/or Mn2+-influx pathways exist in rat aortic SMCs for Mn2+ influx.
These DHP-resistant pathways are unaffected by endothelin-1, PMA or elevated [Ca2+] i. SR constitutes a large Ca2+ pool in SMCs. Thus, the overall rate of 45Ca2+ label equilibration in SMCs depends not only on the efficiency of transsarcolemmal flux but on the size and the Ca2+ pumping activity of the SR Ca2+ pool.View full abstractDownload PDF (1775K) -
A POSSIBLE MECHANISM OF NIGROSTRIATAL CELL DAMAGEAKEMI SOTOMATSU1994 Volume 44 Issue 3 Pages 251-262
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSFerric ions significantly promoted a peroxidative cleavage of unsaturated phospholipids in liposomes in vitro after coordinating with dopa or other catechols. Both α-tocopherol and deferoxamine mesylate completely abolished dopa-iron complex-induced phospholipid peroxidation, while superoxide dismutase, catalase, sodium benzoate, or sodium azide did not, suggesting no participation of superoxides, hydrogen peroxides, hydroxyl radicals, or singlet oxygens in this peroxidation. Spectrophotometric studies indicated the formation of dopa-iron complexes, and yielded a value of 1.3 for the ratio of ligand (dopa) to coordinating metal (ferric ion). Synthetic melanin also promoted lipid peroxidation in the presence of ferric ions. However, superoxides were demonstrated to intervene in that reaction. In conclusion, endogenous catechols and melanin may have cytotoxic effects in concert with iron inappropriately stored or excessively loaded as shown in the substantia nigra in parkinsonian brains.View full abstractDownload PDF (1614K) -
SHINICHI KAKINUMA, TERUO KUSABA, YOSHIHIKO SUZUKI, SUSUMU OHWADA, TOHR ...1994 Volume 44 Issue 3 Pages 263-268
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSBetween 1984 and 1992, thirteen patients with unresectable pancreatic cancer were treated with intraoperative radiotherapy (IOR). One patient had Stage I disease, and 12 had Stage IV according to the General Rules of the Japan Pancreas Society. Nine of these patients underwent postoperative external beam radiotherapy with doses of 26 to 90 Gy. All of the patients underwent both distal gastrectomy with Billroth-II type reconstruction for gastrointestinal bypass and cholecysto-jejunostomy (Roux-Y) for biliary bypass. No postoperative complications due to either IOR or the bypass operations occurred. Median survival time was 12 months, and50% survival time was 10 months. The longest survival period was 36 months. Preoperative pain decreased or disappeared. All of the patients were discharged and a few were able to return to work. Intraoperative radiotherapy with bypass surgery is a useful means of improving the quality of life of patients with unresectable pancreatic cancer.View full abstractDownload PDF (1609K) -
ATSUSHI TAKAHASHI, SHIRO MATSUYAMA, NORIO SUZUKI, MINORU KUROIWA, HITO ...1994 Volume 44 Issue 3 Pages 269-276
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSTo evaluate the clinical features of ascending cholangitis (AC) following portojejunostomy for biliary atresia, 77 cases of AC treated at Gunma Children's Medical Center were studied retrospectively.
The results were as follows : (1) Most of the AC occurred within 2 years after the operation. (2) The group with a recurrence of jaundice and the group operated on more than 41 days afterbirth had a high incidence of AC. (3) Over half of the cases, which had both high fever and a decrease in bile flow, developed jaundice soon thereafter. (4) In twenty-four out of 46 AC, AC recurred within 1-2 months, the decreased bile flow persisted. (5) AC occurring within 2 years after the operation, the group without recurrence of jaundice, and the group operated on within40 days after birth could almost all be treated medically. (6) The effectiveness of medical treatment was not correlated with the degree of jaundice accompanying the AC. (7) Some of the AC cases were effectively treated by surgical methods.
These findings indicate that early diagnosis and surgery of biliary atresia prevents the occurrence of AC, and that active examination and treatment for AC is necessary when a high fever and a decrease in bile flow occur, especially within 2 years after the operation.View full abstractDownload PDF (1081K) -
HITOSHI KODAMA, ICHIROH YOSHIDA, YOSHIMI OHTANI, SUSUMU ISHIKAWA, AKIO ...1994 Volume 44 Issue 3 Pages 277-282
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSIn order to assess the long-term effects of extended thymectomy in myasthenia gravis, 26 patients were evaluated on an annual basis beginning 1 year after surgery. At the time of the final evaluation, remission was observed in five patients (19%), improvement in 13 (50%), no change in five (19%), aggravation in two (8 %) and death in one (4 %). Palliation, including remission and improvement, was observed in 18 (69%). Both the remission and palliation rates increased over the course of time after surgery. There were no significant differences in palliation rates according to Osserman type, sex, age at the time of onset or operation, duration of illness, thymoma, or acetylcholine receptor antibody titers. Extended thymectomy is the treatment of choice for patients with myasthenia gravis without regard to any background factor. Long-term follow-up is necessary since extended thymectomy exhibits a tendency toward delayed remission.View full abstractDownload PDF (691K) -
HIROSHI K. INOUE, HIDEAKI KOHGA, SATOSHI KOBAYASHI, KATSUMI OHBAYASHI, ...1994 Volume 44 Issue 3 Pages 283-287
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSTherapeutic policy and operative approaches to craniovertebral junction anomalies with instability are reported in three representative cases. Gradual traction and as much reforming of the basilar impression as possible were performed for at least 30 days using a halo vest. The operative indication and approaches were decided depending on neurological findings and magnetic resonance images after reforming by traction. Conservative treatment with a neck collar was chosen in an elderly patient without symptoms after reforming by traction. Foramen magnum decompression and occipitocervical fusion with iliac bone and a Luque rod were performed in a patient who showed marked improvement in neurological findings and on MR imaging studies after traction. Both posterior (decompression and fusion) and anterior approaches (transoral odontoidectomy) were performed in a patient who did not respond much to traction therapy. All of the patients were stable after the completion of treatment. We conclude that the halo vest traction-reforming method is useful for assessing operative indications and the subsequent safe application of anterior and/or posterior operative procedures.View full abstractDownload PDF (1712K) -
TOSHIKAZU HIRAI, YOSHIRO HAMADA, TAKAYUKI KANO, ZYUNYA KOBAYASHI, KEII ...1994 Volume 44 Issue 3 Pages 289-295
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSThe outcome of 196 patients with postsurgical pathologic stage I lung cancer was investigated. The overall 5-year survival rate was 73%. The 5-year survival rates of patients with pathologic Ti and T2 disease were 83% and 59%, respectively, and the difference between them was significant (p = 0.0003). Patients aged 70 years or more had significantly (p<0.01) poorer survival than younger patients. Patients with a tumor diameter of more than 3cm had significantly poorer (p<0.01) survival than those with tumors 3cm or less in diameter. Patients with adenocarcinoma tended (p=0.062) to have greater survival rates than those with squamous cell carcinoma. Survival in female lung cancer also tended (p=0.052) to be better than in male lung cancer. There were 50 deaths overall, with 25 patients (12.8%) dying of recurrence (distant metastasis in 21 and local recurrence in 4). Eleven patients (32.4%) whose original lesions were adenocarcinoma pathologically classified as T2 died. Adjuvant therapy is recommended to improve the survival rate of patients with postsurgical pathologic stage I lung cancer, especially those with adenocarcinoma pathologically classified as T2.View full abstractDownload PDF (1105K) -
YOSHIHIRO HAMADA, TOSHIKAZU HIRAI, TATSUMASA ANDO, NAOKI TOMIZAWA, TAK ...1994 Volume 44 Issue 3 Pages 297-302
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSA 69-year-old female successfully underwent the closure of bronchopleural fistula 10 weeks after right lower lobectomy for lung cancer. The fistula was identified at the bronchial stump and the lateral wall of the middle lobe bronchus. Empyema was treated by tube drainage and followed by open window thoracotomy for eight weeks. The bronchopleural fistula was then closed with an omental pedicle. The omentum placed into the pleural cavity was fixed on the fistula as a patch graft. Chest tube drainage was discontinued one week later with no signs of fistula or abscess formation. The postoperative course has been uneventful.View full abstractDownload PDF (1943K) -
KYOICHIRO TSUDA, MASAMICHI KAWABE, TSUNEHIRO ISHIDA, SATOSHI OHKI, KOU ...1994 Volume 44 Issue 3 Pages 309-316
Published: May 01, 1994
Released on J-STAGE: October 21, 2009
JOURNAL FREE ACCESSA 66-year old female was admitted to our hospital because of abnormal shadows on a chest rentogenogram. Computed tomography of the chest revealed marked mediastinal and left hilar lymphadenopathy and a mass, 5 mm in diameter, with pleural indentation in the left lower lung field. The serum CEA level was very high (103ng/ml). Computed tomography also demonstrated a right superior mediastinal lymph node protruding into the right neck. We therefore performed a right neck lymph node biopsy to make a definitive diagnosis. The pathological diagnosis was benign mediastinal goiter. Thus mediastinal lymph node dissection was performed via a right thoracotomy, which revealed lymph node metastases of adenocarcinoma. We then performed a left lower lobectomy and mediastinal lymph node dissection. The final diagnosis was small advanced lung cancer (stageHib) with mediastinal goiter.
A mediastinal tumor with high serum CEA levels suggests the possibility of lymph node metastasis of a small sized lung cancer, however a mediastinal tumors accompanying lung cancer are not necessarily lymph node metastases.View full abstractDownload PDF (4944K)
- |<
- <
- 1
- >
- >|