Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 31, Issue 1
Displaying 1-18 of 18 articles from this issue
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Contents
  • Pathological Studies on Neuro-Behçet's Disease
    HIROTOSHI HAYASHI
    1985 Volume 31 Issue 1 Pages 66-80
    Published: March 10, 1985
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.31.66
    JOURNAL FREE ACCESS
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    Nine autopsied cases of neuro-Behçet's disease were studied pathologically in terms of several clinical features and the neuropathological changes including the vascular changes and the inflammatory processes in comparison with infectious diseases of the central nervous system. The following results were obtained. 1. Clinically, all patients were males and between 20 and 40 years old at the time of onset of neurological symptoms; their mean age was 32.3 years. The duration of illness was prolonged, ranging from one to 17 years, and two out of nine cases presented the neurological changes at the time of onset before or with development of the major symptoms. 2. Histopathologically, neuro-Behçet's disease was characterized by recurrent nonspecific disseminated panmeningoencephalitis with peculiar demyelination and the following characteristics : a) Coexistence of nonspecific acute and chronic inflammations. b) Weak collagen fiber reaction of the vascular wall and the meninx dispite the frequent recurrence and long illness. c) Relatively preserved nerve cells in contrast with the severity of demyelination without any selective degeneration. d) No evidence of primary vasculitis as the initial lesion. e) The site of predilection included mainly the brain stem, followed by the spinal cord, cerebrum and cerebellum. 3. A peculiar presence of foamy histiocytes between nerve fibers was observed without any connection to the softening. This suggested the possibility of the breakdown of myelin or the nerve fiber as the initial lesion, and the consequent histopathological changes were discussed.
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  • Clinical Findings in 171 Cases of Kawasaki Disease
    YOSHIO KANEDA, SHIGEAKI INOUE, TOSHIHIRO INO, MASAHARU TSUDA, SUSUMU F ...
    1985 Volume 31 Issue 1 Pages 81-91
    Published: March 10, 1985
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.31.81
    JOURNAL FREE ACCESS
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    The clinical course and findings of 171 children (97 boys and 74 girls) with Kawasaki disease admitted to our hospital during the 10-year period from March 1973 to July 1983 were studied. 1. Age and incidence The age at onset ranged from three months to nine years. The incidence was the highest among one year-old Children (51/171 cases, 29.8 %), and 95 % (162/171 cases) of the subjects studied were less than five years old. The ratio of boys to girls was 1.3 to 1.0. The seasonal peak incidence was observed in the months from January to June, 1979 and from January to May, 1982. 2. Clinical studies a. MCLS score : MCLS scores in 99 patients without coronary lesions ranged from 0 to 13 points. There were 83 cases with less than 5 pointr (83.8 %) and 16 with, more than 6 points (16.1 %). The scores in 28 subjects with coronary lesions ranged from 2 to 16 points. Among the 28 patients, there were five with less than 5 points (17.9 %) and 23 with more than 6 points (82.1 %). b. Complications : The most important and serious complication is cardiovascular involvement, particularly coronary arteritis. Echocardiography performed in 67 patients demonstrated coronary arterial dilatations and aneurysms in 30.1 % at the acute stage. Of 171 cases, 17 (99.9 %) had neurological symptoms such as meningismus, meningitis, convulsion and abnormal EEG records, seven (4.1 %) arthritic symptoms, and four (2.3 %) enlargement of the gallbladder; thrombocytopenia, nephrotic syndrome and uveitis were seen one case each (0.58 %). The mortality rate was 1.1 % (2/171). Disorders of coronary arteries such as aneurysms, dilatations, infarctions, calcifications, axillary arterial aneurysms and iliac arterial aneurysms were found in 30 cases (17.5 %) 3. Studies on laboratory data a. CRP and ESR : CRP and ESR showed strongly positive at the acute stage or at the relapse stage, but were normalized rapidly with Clinical improvement. In cases with coronary lesions, strongly positive CRP and ESR were sustained longer than in cases without coronary lesions. b. Platelet counts : Mean values of the highest platelet counts in 85 cases without coronary lesions and in 22 cases with coronary lesions, were 73.3±23.8x104/mm3 and 92±2.9x104/mm3 respectively, and the mean durations from the onset of the disease to reaching the peak count were 16±6.5 days for the former and 20±7.7 days for later. c. Serum CH50 and complement proteins : In 28 case without coronary lesions, the values of serum CH50 and complement proteins were elevated at the acute stage and at the relapse stage, but were normalized gradually with clinical improvement. klIn seven out of 14 cases with coronary lesions, the values of CH50 and complement proteins except for C9 and C3b INA dropped transiently from the second to the third week after onset. There after, these were normalized or even rose above normal ranges within about a week, at which time the coronary lesions were found by echocardiography. d. Serum immunoglobulins and immune complexes : The values of serum IgG, IgA, IgM and IgE were elevated at the acute stage and diminished gradually with clinicalimprovement. The volues of serum immunoglobulins in patients with and without coronary lesions showed no significant differences. The elevated circulating immune complexes values of IgG, IgA, IgM and IgE at acute stage, measured by 3%-4% polyethylene glycol (PEG) precipitation and gel filtration, returned to normal ranges during convalescence in subjects without coronary lesions, but, in those with coronary lesions, the values that were not elevated during the early acute stage gradually increased and were sustained in relatively high ranges in the subsequent course. In an autopsy case, those values persisted in higher ranges until the terminal stage.
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  • A CLINICAL STUDY OF HYPERPROLACTINEMIA
    --Variety of Causes, Results of Pituitary, Function Tests and Therapeutic Results--
    MASARU FUKUDA, AKINORI SEIDA, TERUAKI OKUYAMA, HIROSHI FURUYA
    1985 Volume 31 Issue 1 Pages 92-100
    Published: March 10, 1985
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.31.92
    JOURNAL FREE ACCESS
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    The endocrine features of 28 patients with hyperprolactinemia and outcome after treatment were studied. The patients were divided into following three groups, according to the causes of hyperprolactinemia: the pituitary tumor, the drug-induced, and the unknown cause groups, the majority of patients being the drug-induced group of 12 cases. In the pituitary tumor group, serum prolactin levels were higher than in the other groups, and serum FSH levels were significantly lower than those in the control group. Poor prolactin response to TRH was found in both the pituitary tumor and unknown cause groups. Pituitary function of the patients with hyperprolactinemia was observed to be well maintained regardless of the cause of the condition. In a follow-up study, full ovarian response was found in 14 of the 28 patients.
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