JOURNAL OF THE KYORIN MEDICAL SOCIETY

[title in Japanese]

Article type: Cover
1992 Volume 23 Issue 3 Pages Cover9-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.Cover9

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[title in Japanese]

Article type: Cover
1992 Volume 23 Issue 3 Pages Cover10-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.Cover10

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The Need for High Priorities in Preventive Health Care Administrations in Both Developed and Developing Countries

Takashi AKAMATSU, Dalmas A. R. DOMINICUS, Yutaka TAKASHIMA, Makoto ARI ...

Article type: Article
1992 Volume 23 Issue 3 Pages 389-400
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.389

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The knowledge of prevention is of primary importance if we are to achieve the goal of health for all by the year 2000, which is less than a decade ahead. In this paper, we intend to enlighten all health professionals as well as health administrators of the importance of preventive medicine in the promotion of health. In terms of cost, prevention is considered an investment in health that produces reduced probability of morbidity and mortality. Because preventive measures have an impact on future health care expenditures and incomes (in terms of production), they should be accorded top priority in health care planning in both developed and developing countries. Preventive health care (preventive medicine) as used in this paper includes not only medical care, but also life-style activities relating either to access to education, water, employment and income, or to reducing unhealthy consumption patterns, such as inadequate exercise and poor nutrition (unbalanced diet).

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The Effect of Blood Transfusions on Cancer Patient Prognosis

Noriyoshi TAKEUCHI

Article type: Article
1992 Volume 23 Issue 3 Pages 401-417
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.401

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To evaluate the prognostic influence of blood transfusions for cancer patients, the transfusion data of colon, stomach and breast cancer patients who had undergone radical operations were reviewed. The recorded data included a number of background factors. The endpoints considered were terminal colon and stomach cancer, and recurrent breast cancer. Colon cancer patients who received transfusions had a lower survival rate than those who did not (P<0.0001), while the reverse was true for breast cancer patients (P<0.05). The effects in mice (C3H/He) of blood transfusion on growth of subcutaneously inoculated tumor cells was studied. 1) Tumor growth rate was significantly altered by transfusion of allogeneic blood. Two weeks after cell inoculation, tumor size with transfusion was 269.1±33mm^2, and without 145±13mm^2. 2) Tumors were significantly larger when lymphocyte, lymphocyte and monocyte, or whole blood was transfused than in cases of non-transfusion. Tumor size in cases of plasma or serum transfusion was the same as in non-transfusion cases. 3) NK lysis was significantly lower in transfusion cases than in nontransfusion cases.

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Direct Ovarian Effect of Gonadotropin-releasing Hormone Agonist : with Special Reference to Mechanism of Oocyte Maturation

Motomu ANDO

Article type: Article
1992 Volume 23 Issue 3 Pages 419-432
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.419

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The effect of gonadotropin-releasing hormone (GnRH) agonist on in vitro maturation of rabbit follicleenclosed oocytes was studies. Rabbit preovulatory follicles were cultured in vitro for 14 hours with hCG (1OOng/ml), GnRH agonist (10^<-9>-10^<-6>M), or GnRH agonist (10^<-7>M) plus GnRH antagonist (10^<-8>-10^<-6>M). GnRH agonist induced the meiotic maturation of follicle-enclosed oocytes in a dose-dependent manner while concomitantly increasing oocyte degeneration. GnRH agonist significantly stimulated prostaglandin (PG) production by preovulatory follicles, but levels of PG secretion were not significantly different among the different concentrations of GnRH agonists. Meiotic maturation of follicle-enclosed oocytes following exposure to GnRH agonist began two hours earlier than production of PG. PG production stimulated by GnRH agonists was significantly reduced by indomethacin. Oocyte maturation in the presence of GnRH agonist plus indomethacin, however, did not significantly differ from that with GnRH agonist alone. The simultaneous addition of GnRH antagonist significantly inhibited oocyte maturation induced by GnRH agonist and PG production by the mature follicles. Furthermore, GnRH antagonist reversed the rate of oocyte degeneration that had been increased by GnRH agonist. The rates of normal fertilization and early embryonic development in oocytes matured by GnRH agonist were significantly reduced in comparison with oocytes matured by hCG. These results suggest that GnRH agonist acts directly on mature rabbit follicles to trigger meiotic maturation of oocytes by a mechanism other than PG stimulation, but oocytes matured in vitro by GnRH agonist are not necessarily cytoplasmically maure.

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Effects of α_2-Adrenergic Antagonist Yohimbine on Maternal Behavior in Primiparous Rats

Akiko DOUBUTSU

Article type: Article
1992 Volume 23 Issue 3 Pages 433-441
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.433

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The contribution of an adrenergic mechanism to the outset of maternal behavior was pharmacologically investigated in primiparous rats. Subcutaneous administration of 3.0mg/kg yohimbine, an α_2-adrenergic antagonist, suppressed the outset of maternal behavior, but not a dose of 0.3mg/kg. These suppressive effects of yohimbine were blocked by pretreatment with clonidine, an α_2-adrenergic agonist. Intracerebroventricular administrations of 15.0μg/rat and 30.0μg/rat relatively suppressed the outset of maternal bahavior. These suppressive effects of yohimbine also were blocked by pretreatment with clonidine. The α_2-adrenergic agonist and antagonist methoxamine and prazosin did not effect maternal behavior when injected, subcutaneously. These results indicate tha tthe central α_2-adrenoceptor has an important role in the outset of maternal behavior in rats.

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Arterial Supply in the Human Triceps Brachii Muscle

Jun IGARASHI

Article type: Article
1992 Volume 23 Issue 3 Pages 443-463
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.443

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Littel is to be found in the literature on the arterial supply in the human triceps brachii muscles. The author has studied 50 sides of 25 adult cadavers and achieved some worthy results. The posterior circumflex humeral (Chp) and circumflex scapular (Cs) arteries are distributed in the upper portion of the triceps brachii muscle, the muscular branch (Rm), deep brachial (Pb) and superior ulnar collateral (Cus) arteries in the central portion, and the inferior ulnar collateral (Cui) artery in the lower portion. Each had of the triceps brachii muscle was classified in accordance with the origins and distribution patterns of the arteries. (1) Long head of triceps brachii muscle : Among several types, Type I -a with Chp, Cs, Rm, Pb, and Cus accounted for the largest number, or 36.0 %, followed by Type II-a, which lacked Rm, with 30.0 %. (2) Medial head of triceps brachii muscle : Type I -a, which had Pb, Cus, Rm, and Cui accounted for 58.0%. (3) Lateral head of triceps brachii muscle : Type I -a, 32.0 %, and Type II-a, 30.0 %, were observed. Type I -a had Pb, with a long common stem of radial collateral (Cr) and middle collateral (Cm) arteries, and Chp. Type II lacked Chp. It was found that 41 of the 50 long heads and all medial and lateral heads had Pb. The mean areas of distribution in the three heads were 40.7 %, 59.5 %, and 91.1%, respectively.

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In vivo Biomicroscopy of the Human Cornea and Lens Fiber

Taketsugu ISHIWATA

Article type: Article
1992 Volume 23 Issue 3 Pages 465-476
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.465

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Endothelium of the cornea, which appears to play an important role in the maintenance of corneal transparency, was studied in vivo with a specular microscope in order to elucidate changes associated with the ageing process and disease of the cornea. Fifty-six normal eyes of persons aged from 6 to 81 were examined with the specular microscope. The microphotographs obtained were analyzed with respect to the effect of ageing. The decrease in cell density with age was represented by a statistically significant linear regression. Specular microscopic studies were conducted of the corneal endothelium of the eyes of 5 patients affected by birth injuries. The affected eyes demonstrated a significant decrease in endothelial cell density. Specular microscopic studies were conducted of 11 patients with unilateral involvement of posterior corneal vesicles. Endothelial cell density decreased with age, but the rate of decrease was similar to that of unaffected eyes. The human lens was observed in vivo with a specular micr scope an especially-designed cone contact lens. The lens fibers of the central part of the anterior cortex of 16 normal healthy males in their third and fourth were photographed and their widths were measured. The average widths of the fibers were, respectively, 12.35±1.17μ/m and 12.36±0.80/μm.

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Effects of Branched-chain Amino Acid-rich Diet on Decompensated Liver Cirrhosis : Experimental and Clinical Studies

Hiroshi NAKAJIMA

Article type: Article
1992 Volume 23 Issue 3 Pages 477-488
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.477

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The effects of branched-chain amino acids (BCAA) on the nutritional condition and regeneration of the liver were studied in rats with carbon tetrachloride-induced cirrhosis. A clinical study of the effects of a supplementary BCAA-rich enteral nutrient on hepatic failure also was carried out. The administration of BCAA demonstrated improvement of a deteriorated nutritional state and acceleration of regeneration of the liver when the food intake is adequate. Also conducted was a clinical trial of long-term administration of BCAA to patients with decompensated liver cirrhosis. A supplement of BCAA-rich enteral nutrient for hepatic failure improved a poor nutritional condition, prevented the recurrence of hepatic encephalopathy, and improved the quality of life of each patient.

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The Importance of Atrial Filling Wave in Myocardial Infarction

Konomi SAKATA

Article type: Article
1992 Volume 23 Issue 3 Pages 489-501
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.489

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Changes in transmitral flow and the clinical course of 112 patients with myocardial infarction were monitored from the acute phase to one year after onset. The clinical importance of the peak velocity of atrial filling was verified. The patients were divided into three groups in accordance with the peak atrial filling velocity in the acute phase. As compared with values obtained from age-matched normal controls, the velocity decreased in 31 patients (28 %) (Group L), similar in 68 (61 %) (Group N), and increased in 13 (12%) (Group H). During the acute phase, 22 (70.9 %) of the 31 patients in Group L suffered severe heart failure which resulted in the death of 2 (13.3 %). In Groups N and H, only a few patients suffered heart failure and death during the acute and chronic phases. Pulmonary artery wedge pressure in Group L, as measured with a Swan-Gantz catheter, increased significantly to 17.9±7.8 mmHg, with a significant decrease of the cardiac index to 2.2±0.71 l/min/m^2, during the acute phase. During the chronic phase, LVEF significantly decreased to 40.6 ±12.5%. In addition, 13 patients in group L had associated mitral regurgitation with hypertrophy of the left atrium of up to 35 mm or more in diameter. Of these 13 patients, 9 (69.2 %) died. Prognosis appears to be poor when peak atrial filling velocity decreases during the acute phase of mitral regurgitation with hypertrophy of the left atrium as a result of decreased cardiac output and elevation of left atrium pressure.

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Treatment of Uterine Leiomyomata with a Long-acting Gonadotropin-releasing Hormone Agonist

Hajime MATSUDA

Article type: Article
1992 Volume 23 Issue 3 Pages 503-512
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.503

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The present study was undertaken to evaluate the efficacy of monthly subcutaneous administration of a long-acting gonadotropin-releasing hormone agonist (GnRHa, leuprolide acetate, TAP-144-SR) in the treatment of uterine leiomyomata. Twenty patients, aged 41 to 53, with leiomyomata were treated with TAP-144-SR for 6 months. All patients experienced amenorrhea 8 weeks after the onset of treatment, whereas the resumption of menstruation occurred in 18 patients after the cessation of treatment. There was a significant increase in hemoglobin concentration after 20 weeks of treatment. This increase reflected the diminution of menstrual blood loss. After the initial transient stimulation, serum levels of luteinizing hormone (LH) were suppressed during therapy with TAP-144-SR. The serum levels of follicle-stimulating hormone (FSH) dropped within a week, remaining at a relatively steady level. Serum levels of E_2 increased until 2 weeks after the onset of treatment and abruptly declined to menopausal levels (<30pg/ml). A statistically significant reduction in uterine volume was observed 8 weeks after the onset of treatment. After cessation of therapy, however, mean uterine volume increased to pretreatment values. There was a significant correlation (p<0.001) between the percentage of uterine volume reduction and the degree of hypoestrogenism achieved during the therapy. In 2 patients who reached menopause after treatment, LH, FSH and E_2 serum levels remained in the castrate range, resulting in no further significant change in uterine volume. In conclusion, monthly subcutaneous administration of TAP-144-SR was clinically effective in significantly decreasing uterine volume and increasing hemoglobin concentration in patients with leiomyomata.

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Clinical Activity of the Department of Thoracic and Cardiovascular Surgery : January 1987 through December 1991

Akira MIZUNO

Article type: Article
1992 Volume 23 Issue 3 Pages 513-517
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.513

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Clinical activities in the Department of Thoracic and Cardiovascular Surgery during a five-year period from January, 1987, through 1991 are summarized. Including such major and minor operations as stripping of varicose veins and the creation of dialysis shunts, we have surgically treated 1300 cases during the 5 years, the number increasing annually. In review, operations involving the heart, major and minor vessels, lungs, mediastinum and implantation of cardiac pacemakers were almost constant. However, operations involving aneurysmal dissection and raptured aneurysms were on the increase as emergency cases. There has been a predominant increase in the past two years of operations for abdominal aortic aneurysms. During the same 5-year period, we operated on two cases of malignant heart tumors which are considered to be very rare. Operations involving the thoracic and abdominal aorta and malignant tumors of the heart are described in detail, and special references are presented.

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[title in Japanese]

Article type: Appendix
1992 Volume 23 Issue 3 Pages 519-520
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.519

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[title in Japanese]

Article type: Appendix
1992 Volume 23 Issue 3 Pages 521-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.521_1

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[title in Japanese]

Article type: Appendix
1992 Volume 23 Issue 3 Pages 521-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.521_2

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[title in Japanese]

Article type: Appendix
1992 Volume 23 Issue 3 Pages 521-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.521_3

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[title in Japanese]

Article type: Appendix
1992 Volume 23 Issue 3 Pages App8-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.App8

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[title in Japanese]

Article type: Appendix
1992 Volume 23 Issue 3 Pages App9-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.App9

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[title in Japanese]

Article type: Appendix
1992 Volume 23 Issue 3 Pages App10-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.App10

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[title in Japanese]

Article type: Cover
1992 Volume 23 Issue 3 Pages Cover11-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.Cover11

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[title in Japanese]

Article type: Cover
1992 Volume 23 Issue 3 Pages Cover12-
Published: September 30, 1992
Released on J-STAGE: February 13, 2017

DOIhttps://doi.org/10.11434/kyorinmed.23.Cover12

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