JOURNAL OF THE KYORIN MEDICAL SOCIETY
Online ISSN : 1349-886X
Print ISSN : 0368-5829
ISSN-L : 0368-5829
Volume 18, Issue 2
Displaying 1-27 of 27 articles from this issue
  • Article type: Cover
    1987 Volume 18 Issue 2 Pages Cover5-
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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  • Article type: Cover
    1987 Volume 18 Issue 2 Pages Cover6-
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
    JOURNAL FREE ACCESS
    Download PDF (185K)
  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages App4-
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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  • Teiji MOTOJIMA, Kin-ichi NABEYA, Kimio ONOZAWA
    Article type: Article
    1987 Volume 18 Issue 2 Pages 165-174
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    One hundred-five mortality cases of recurrent carcinoma of the esophagus following esophagectomy were divided into four groups according to the type of first-site recurrence. They were: cervical first-site recurrence 18.1%; thoracic 41.9%; abdominal 13.3%; other distant metastasis 26.7%. The intervals from esophagectomy to the first-site recurrence differed with the type of first-site recurrence and the degree of operative curability. In thoracic first-site recurrence and distant metastatic cases that underwent curative resection, the interval was 15 to 20 months and for the non-curative resection cases, this was within 6 months. In cervical first-site recurrent cases, the interval was 24 months for curative resection cases and within 6 months for non-curative cases. In abdominal first-site recurrent cases, the interval was 6 months and within 5 months respectively. Survivals over 12 months after treatments of recurrence were seen in 21.0% of the cervical first-site recurrent cases and in 4.5% to 7.1% in the other cases. To improve the results in the treatment of recurrent carcinoma of the esophagus, it is most important to diagnose the recurrence as fast as possible. Prior to manifest the first-site recurrence, the cervical lymph nodes, the abdominal masses and liver must be carefully palpated. Again, it is vital to pay heed to symptoms of hoarseness, cough, hemoptoe, emaciation and anorexia. Pains in the back and lower back may be significant to the beginning of recurrence and observation must be made.
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  • Takashi TAMURA, Hiroki HOSHINA
    Article type: Article
    1987 Volume 18 Issue 2 Pages 175-178
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    The incidence of spontaneous abortion in our country is said to be about 10%. It is also reported that about 50% of the abortuses have chromosome abnormalities and there are some balanced translocation carriers among the aborting parents. Taking these data into consideration, chromosomal analyses were made on 74 couples who had experienced spontaneous abortion more than twice. As a result, three couples of them were found to be balanced translocation carriers(wives only in either case); respective chromosome karyotypes were 46, X X, t (2 ; 18) (q 32; q 23), 46, XX, t (2 ; 12) (p 15 ; P 13), 46, XX, t (9 ; 21) (q 32 ; q 22). Case 2 and 3 having children, further analyses were made on them. The studies revealed that one of the children had a normal karyotype and another was a balanced translocation carrier who had the same karyotype as its mother. In the event that balanced translocation carriers are found in couples with histories of miscarriage, genetic counselling is necessary for them thereafter, because of high recurrence risk of chromosomal abnormalities.
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  • Toshiaki KOBAYASHI, Nobuo WATANABE
    Article type: Article
    1987 Volume 18 Issue 2 Pages 179-183
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    Since autumn in 1981, the new pertussis component vaccine has been used. Component means pertussis toxin (PT) and filamentous hemagglutinin (F-HA), and the method for measurement of these new antibodies have been made. Then we studied for anti PT and anti F-HA antibody. The subjects are 57 children with DPT vaccination, 28 children without DPT vaccination, 7 children contracted with pertussis and 300 pregnants. We conformed the micro ELISA method by Sato, National Institute of Health. For the effective antibody titer, we set over 10 ELISA UNIT (EU) in both antibodies according to the recent reports. Result In DPT vaccinated children, both anti PT and anti F-HA antibody were tendency to decrease as years after vaccination. In 7 out of 20 cases (35%) over 10 years after vaccination, both levels showed below 10 EU, it's seemed that they have probability of suffering from whooping cough. And in cases of less 5 years after vaccination, the positive rate of anti F-HA antibody showed higher than anti PT antibody. Out of 28 children without DPT vaccination, anti PT antibody in 2 cases (7.1%) and anti F-HA antibody in 3 cases (10.7%) showed below 10 EU. Non of them had neither anti PT nor anti F-HA antibody titer more than 10 EU. It means 5 cases of them (17.8%) have the antibody titer of protecting infection. It is suggested that subclinical infection exists in them. In 7 children contracted pertussis, anti PT antibody showed 10 EU or more in all of them, but anti F-HA antibody showed 10 EU or more in only 2 cases. In 26 cases out of 300 pregnants, both anti PT and anti F-HA antibody showed below 10 EU. It is known that both anti PT and anti F-HA antibody transfer to fetus through placenta, then they and their newborns have probability of suffering from whooping cough. So it's in need of reference the mother without these antibodies, for protection of pertussis infection in newborns.
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  • Noriko HASEGAWA
    Article type: Article
    1987 Volume 18 Issue 2 Pages 185-194
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    Pulmonary tissues obtained from 12 individuals suffering from congenital heart disease accompanied with Down syndrome were examined by light and transmission electron microscopy and compared with those of 29 cases without the syndrome. Alkaline phosphatase (ALPase) activity was histochemically examined and compared as well. Ultrastructural changes found in the pulmonary tissues examined from the patients with pulmonary hypertension were as follows: 1) infolded and twisted basement membrane along the abluminal surface of the capillary, 2) a thickened capillary wall composed of the endothelial cell cytoplasm, 3) accumulation of collagenous fibrils within the enlarged pericapillary interstitial space, 4) increase in the number of type II alveolar cells. These changes were more conspicuous and encountered more frequently in the pulmonary hypertensive individuals with Down syndrome than in those without the syndrome. Furthermore, they were detected at an earlier age in the patients with Down syndrome. ALPase activity, which is known to be important in the secretion of pulmonary surfactant, was detected in the plasma membrane of type II alveolar cells and in the limiting membrane of the osmiophilic bodies. Activity was more intense in the pulmonary tissues obtained from the patients suffering from pulmonary hypertension than in those from the patients without the hypertension, irrespective of Down syndrome. These observations may indicate that the alveolar tissue including the type II alveolar cells and the capillary endothelium are affected at an earlier stage in the patients with Down syndrome. The increase in ALPase activity as stated above seems to correlate with changes in the structure of the type II alveolar cell and also with the secretion of the pulmonary surfactant.
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  • Yasushi SATO, Toyoharu TAKAFUJI
    Article type: Article
    1987 Volume 18 Issue 2 Pages 195-211
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    The authors examined the branching condition of each artery of A. axillaris in 50 bodies of the Japanese adults with 100 side cases and have reported here some interesting results. 1) The frequencies of the independent branches of six branches (A. thoracica suprema, A. thoracoacromialis, A. thoracica lateralis, A. subscapularis, A. circumflexa humeri anterior and A. circumflexa humeri posterior) which have been reported in NOMINA ANATOMICA are 86%, 69%, 45%, 45%, 64% and 25% respectively. As branching condition of whole A. axillaris, Type A-VI (all of 6 arteries are the independent branches) is up to 16% with the highest frequency. This is almost the same in frequency as the former reports. 2) The following four arteries have not been listed in NOMINA ANATOMICA. a) Ramus partis abdominalis (Rab, SATO, '76; runs with Nn. pectorales inferiores and is distributed at Pars abdominalis of M. pectoralis major). b) A. subscapularis superior (Sss, Huelke, '59; runs with N. subscapularis superior and is manly distributed at the upper part of M. subscapularis). c) A. coracobrachialis (Cb, SATO, '80; runs with N. musculocutaneus and is mainly distributed at M. coracobrachialis). d) A. processus coracoideris (Pc, SATO-TAKAFUJI, '85; comes from the 2nd part and is distributed around Processus coracoideus). As to the frequency, the incidences of the independent branches of 4 arteries (Rab, Sss, Cb and Pc) are 44%, 39%, 90% and 62% respectively, and they are missed in 14%, 0 %, 1 % and 32% respectively. Therefore, they can be considered as the arteries which exist in all the cases. 3) In 2 cases A. circumflexa humeri posterior has been observed with 2 branches, which have not been reported as yet. 4) In the variational case, A. branchialis superficialis exists up to 10% of all the cases (1 case of them has not been included in the classification by Adachi).
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  • Tetsuya TASAKA, Mamoru TASHIRO, Yoshiteru ZAHA, Tadako IKEDA, Ryuichir ...
    Article type: Article
    1987 Volume 18 Issue 2 Pages 213-223
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    The authors carried out mass health screening on 205 persons to obtain the epidemiologic keynote of S town, no doctor area in Hokkaido, where high standardized mortality rate based on heart diseases was observed. In view of the findings, following summary was obtained. 1) In the subjects examined, about 30 percent in each of the male and female showed hypertensive sign. 2) Various lipid ingredients in the blood of the female with hypertension showed significant high level individually, and then it was supposed that they played some important roles in the high standardized mortality rate based on heart deseases. 3) Hyperlipoidemia of the male with hypertension was not so severe as that of the female, and then it was assumed that hypertension in the male played in itself as an accelerative factor contributing to the high standardized mortality rate based on heart diseases. 4) Differences in volume of blood lipid ingredients between the male and the female were recognized in spite of the fact that the physical check-up was conducted in the same district. We pressumed that this discrepancy in blood lipids was resulted from several factors, such as improvement in quality of diet, increase of caloric intake. 5) On account of the management of hypertensive or subhypertensive patients, it could be effective to put the matters mentioned below into practice not only measurement of blood pressure but also prevention of fatness, control of blood lipids, and examinations by electrocardiography and cardiosonography. 6) Urinary NAG activity indicated high level in the male with hypertension, but obvious mechanisms are unclear and remained in feature.
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  • Tokui EN
    Article type: Article
    1987 Volume 18 Issue 2 Pages 225-230
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    An inhibition enzyme-linked immunosorbent assay (IELISA) was used to detect schistosome antigens. Preparations were obtained from eggs, female adult worms and male adult worms of Schistosoma japonicum. Using appropriate titers of S. japonicum infected mouse serum (IMS), it was possible to detect less than 0.05μg/ml of soluble egg antigens (SEA) added to phosphate-buffered saline. The sensitivity of IELISA was dependent upon the concentration of IMS used, as well as upon the source of antigens. The IELISA utilizing IMS was not suitable for the detection of male worm antigens. Specificity studies showed that no cross-reactivity was observed between SEA and worm antigens. SEA preparations crossreacted with egg glycoprotein fractions more than with egg protein fractions. The IELISA utilizing IMS can quantitate the degree of antigenic cross-reactivity, and can determine the distribution of antigens by using appropriate blocking antigens.
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  • Hideharu TANAKA
    Article type: Article
    1987 Volume 18 Issue 2 Pages 231-244
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    Cardiorespiratory alterations during the 7-day period after injury were evaluated in 83 multiple trauma patients with severe chest injury. In 53 patients without severe head injury, the degree of cardiorespiratory responses were proportional to the grade of the injury severity score. The most striking physiological changes during the first 3 days were elevated pulmonary vascular resistance index and decreased right heart function due to pulmonary vascular microembolism and cardiac contusion. Also, decreases in pulmonary oxygenation and oxygen delivery were noted. In 27 patients with severe head injury, systemic hypertension, elevated systemic vascular resistance index, low cardiac output, and decreased oxygen delivery had persisted until brain death developed. Those physiological changes resulted from increased sympathetic nervous activity and hypovolemia induced by the administration of osmotic diuretics. In 13 patients who had developed posttraumatic respiratory failure due to pulmonary contusion, 2 hour-infusion of prostaglandin Ei in the right atrium significantly improved right cardiac function, pulmonary oxygenation, oxygen delivery, and urine output. It is concluded that multiple trauma patients with severe chest injury should be carefully monitored and aggressively managed so as to maintain physiological parameters at the optimal values. Also, it is suggested that prostaglandin E_1 is a drug of choice for treating trauma patients with acute respiratory failure, and possibly for those with multiple systems organ failure.
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  • Kiyoshi ATSUMI
    Article type: Article
    1987 Volume 18 Issue 2 Pages 245-261
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    Pathology of the liver cell injury was studied on the 216 ddy mice after single oral administration of chloramphenicol in a dose of 50mg (group 1) or continuative administration of 50mg a day for 15 days (group 2). The changes induced in the liver were more severe in group 2, in which there occurred cristolysis and mitochondriolysis. Around the mitochondria adjacent to the nucleus of the liver cell, there was parallel proliferation of the rough endoplasmic reticulum as well as marked increase in ramifying smooth endoplasmic reticulum. In certain places, the continuity of the rough endoplasmic reticulum to the smooth endoplasmic reticulum became evident. In gorup 2, furtheremore, small regenerated mitochondria with dense matrix appeared in addition to megamitochondria and irregular shaped mitochondria on the day 8 or later on. Then, the value of P/O ratio, respiratory control index and succinate dehydrogenase activity was decreased. The results have indicated that the deformed mitochondria, manifested during the regeneration process, function poorly in the energy production. An increase in number of the smooth endoplasmic reticulum and of the peroxisome can be regarded as the morphological indices in the detoxication process of chloramphenicol. It has been suggested conclusively that continuative administration of chloramphnicol can cause a severe deterioration in the function of liver.
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  • Yukio WAKABAYASHI, Kiyoyuki SEKI, Koji KIYOKAWA, Yoshikazu YOSHINO, To ...
    Article type: Article
    1987 Volume 18 Issue 2 Pages 263-270
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    A 44-year-old man was diagnosed to have hemophilia A when he was 6 years old. A large quantity of highly purified Factor VIII preparation was transfused in 1980 and 1983 for the treatment of hemophilia. The patient had been well until August 1985 when he was aware of general fatigue. Slight fever, anorexia, night sweat, diarrhea and dysesthesia in the extremities appeared from January 1986. Owing to high fever, chronic diarrhea and severe cough continued from the begining of May, he was admitted to our hospital on May 15, 1986. On admission, he was emaciated (height 173cm, weight 50kg). Body temperature was 38.6℃. Cervical lymphadenopathy was palpable bilaterally. Moist rales in the chest and hepatomegaly were detected. In neurological examination, consciousness was clear and cranial nerves were normal. Meningeal sign was negative. There were sensory disturbances which showed the type of polyneuropathy. Deep reflexes were reduced. Pathological reflexes were negative. In laboratory examinations, the leucocyte count was 4700/μl and the total lymphocyte count was 470/μl in peripheral blood. Biochemistry showed liver damage and increased γ-globulin. There were a remarkable decrease in T4 cell count and a marked reduction of OKT4/OKT8. IgG, IgA and IgM were increased. Tuberculin test was negative. Human immunodeficiency virus (HIV) antibody was positive. The first chest X-P disclosed sporadic nodular shadows in the both lungs, especially in the left Ss region. After one week, chest X-P revealed pleural effusion, from which mycobacterium tuberculosis was detected. Brain CT scan showed low density area in the left parietal lobe. There were diffuse slow waves of low voltage in EEG. No evidence of Kaposi's sarcoma was found. The patient was diagnosed to have been suffering from acquired immunodeficiency syndrome (AIDS). Remarkable cellular immunodeficiency and several opportunistic infections with positive HIV antibody were considered to account for his severe state. He died two weeks after admission. In the literature of U.S.A., pneumocystis carinii pneumonia is the most common in pulmonary complications of AIDS. But tuberculosis is also seen occasionally. Neurological complications have high frequency. Approximately one-third of AIDS patients have neurological complications, and moreover, the initial symptoms are neurological in 10% of all AIDS patients. Damage to the central nervous system is frequent. But peripheral neuropathy is also seen occasionally. So far 26 AIDS patients were detected in Japan. But neurological complications and pulmonary tuberculosis in AIDS, both of which were confirmed in our patient, seem to be presently very rare in Japan.
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  • Takeo IWATA, Hiromi IKEZAKI, Ikuo IKEDA, Tomeo MORIYA, Yoichi SATONAKA
    Article type: Article
    1987 Volume 18 Issue 2 Pages 271-276
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    The radiotherapy treatment at Kyorin University has started since Dec., 1970. Though we have been using the deeptherapy unit HL5 taken over from Shnikawa Hospital, introducing new treatment facilities, we have always tried to study the better treatment. And now, we need to keep this better treatment, but at the same time, we should reconsider our treatment and patient's data since 1970. We examined the relation between radiotherapy dept. and others and the contribution for environment around university in order to maintain the latest radiotherapy treatment as the university.
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  • Hiroo MATSUDA, Harumi YAJIMA, Hiroshi HIROSAWA, Ren HASEGAWA, Munemits ...
    Article type: Article
    1987 Volume 18 Issue 2 Pages 277-282
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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    The cumurative number of patients admitted to neonatal intensive care unit (NICU) of Kyorin Medical Center was 144, including two readmission patients and three infants for the purpose of mechanical ventilation. Then the number of neonates was 139. Among 18 extremely premature infants 17 (92%) were survived. Seven infants died and major cause of death was persistent pulmonary hypertension of newborn (2 cases) and bacterial infection (sepsis, meningitis and/or disseminated intravascular coagulation, 3 cases). Freezecoagulation and photocoagulation of retina were carried out for two extremely premature infants with retinopathy of prematurity (ROP). Vitamin E supplementation for the prevention of ROP has not been fully evaluated at this monent. All the major congenital anomalies including diaphragmatic hernia, duodenal atresia, esophageal atresia and macrocephalus were diagnosed in utero by ultrasonography. The case of Bochodalek hernia was performed operation immediately after cesarean section and showed satisfactory result. Strict breast feeding was carried in extremely premature infants and necrotizing enterocolitis did not developed. Recently vertical transmission from mother to infant of human T-cell leukemia virus (HTLV)-I [adult T-cell leukemia (ATL)] and HTLV-III [acquired immune deficency syndrome (AIDS)] even through breast milk are attracted attension. Screening tests of both ATL and AIDS are planning. Follow-up clinic for the high risk babies was started. Tsumori-Inage method and MCC baby tests are using for the evaluation of the child development.
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages 283-374
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages 375-381
    Published: June 30, 1987
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages 382-383
    Published: June 30, 1987
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  • Article type: Bibliography
    1987 Volume 18 Issue 2 Pages 384-
    Published: June 30, 1987
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages 385-
    Published: June 30, 1987
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages 385-
    Published: June 30, 1987
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages 385-
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages App5-
    Published: June 30, 1987
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages App6-
    Published: June 30, 1987
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  • Article type: Appendix
    1987 Volume 18 Issue 2 Pages App7-
    Published: June 30, 1987
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  • Article type: Cover
    1987 Volume 18 Issue 2 Pages Cover7-
    Published: June 30, 1987
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  • Article type: Cover
    1987 Volume 18 Issue 2 Pages Cover8-
    Published: June 30, 1987
    Released on J-STAGE: February 13, 2017
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