Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 32, Issue 2
Displaying 1-15 of 15 articles from this issue
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Contents
  • Long-term Prognosis of 602 Patients with Coronary Artery Disease Treated Medically and Surgically
    HIROSHI UCHIDA
    1986 Volume 32 Issue 2 Pages 140-154
    Published: June 10, 1986
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.32.140
    JOURNAL FREE ACCESS
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    The long-term prognosis of medical and surgical therapy was studied in 602 Japanese patients with coronary artery disease documented by coronary arteriography performed from September 1975 through December 1982.Three hundred eighty-seven patients received medical therapy, and 215 underwent surgical therapy. The five-year cumulative survival was 87.3% in the medical group and 95% in the surgical group. According to the vessels involved, the five-year cumulative survival rates in patients with single-, double-, and triple-vessel and left main trunk disease were 91.4%, 80.8 %, 88.7%, and 77.9% in the medical group and 100%, 98%, 95.7%, and 82.1% in the surgical group, respectively. The operative mortality was 1.9%. These results suggest that the prognosis of, Japanese victims of coronary artery disease is similar to the recent findings in the United States and Europe among patients treated medically and surgically.Postoperative angiographic examinations were performed in 28 symptomatic and 33 asymptomatic patients. The graft patency was 75.3%. The most frequent stenotic lesion in vein grafts was found at distal anastomosis, but in seven patients, various degrees of obstructive lesions were found in the vein graft itself. In one patient in paticular, nine years after surgery, the vein grft showed diffuse wall irregularity, a slit-like stenotic lesion and dilatation. These findings may have been atherosclerotic changes in the vein graft. Compared with the preoperative coronary arteriograms, 47.9% of the patients showed progression of coronary obstructive lesions in grafted arteries and 9.4% in nongrafted arteries. But in grafted arteries, most progression was present in the proximal segment or at anastomosis, only 7 % showing progression in the distal segment. Thus, there was no significant difference in progression between the distal segments of the grafted and nongrafted arteries.
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  • Clinical Study on the Genesis of Coronary Atherosclerosis
    -The Relation of Hypertriglyceridemia To Coronary Atherosclerosis-
    YOUNG JOON LEE
    1986 Volume 32 Issue 2 Pages 155-166
    Published: June 10, 1986
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.32.155
    JOURNAL FREE ACCESS
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    Clinical Study On The Genesis Of Coronary Atherosclerosis-The Relation Of Hypertriglyceridemia To Coronary Atherosclerosis-To assess the metabolic effects of plasma triglyceride on coronary atherosclerosis, we made a study of 74 male patients aged 32-71 years undergoing selective coronary angiogr aphy for suspected coronary heart disease as to catabolic aspect of the very low-density lipoprotein (VDL) metabolism. Lipid concentrations of lipoprotein subfractions were measured after preparative ultracentrifugation : Plasma and VLDL apoprotein concentrations were measured by single radial immunodiffusion method (SRID). Activities of lipoprotein lipase (LPL) and hepatic triglyceride lipase (H-TGL) in postheparin plasma were measured by14c radio assay, and the reactivity of VLDL as a substrate upon which purified bovine lipoprotein acts was ascertained by enzyme assay. A coronary score reflecting the number and degree of stenosis in the four major coronary arteries was assigned to each angiogram. It was suggested that increased serum triglyceride not only induced an increase in the number of VLDL particle, but also made characteristic changes in each lipoprotein particle as a result of the increment of the triglyceride ratio. These phenomena were found to be particularly obvios in VLDL. Men with moderate or severe hypertriglyceridemia had a defect of triglyceride clearance from the stand points of both decreased activity of lipoprotein lipase and decreased reactivity of VLDL to LPL.Concentrations of apo C- II and apo C-III in the serum and VLDL had a positive correation with the serum triglyceride concentration, and VLDL apo C-III (as concentration or as percentage of total VLDL) had a negative correlation with VLDL-reactivity. In severe hypertriglyceridemia, the decreased reactivity of VLDL to LPL was most likely due to the increment of apo C-III in VLDL. Therefore, it is necessary to study the reactivity of VLDL as a substrate upon which LPL acts, at the same time studying the activity of enzymes such as LPL and H-TGL. Patients with high coronary scores tended to have higher plasma triglyceride and total cholesterole, but the tendency showed individual differences. Men with higher serum triglyceride besides a high coronary score had a defect of triglyceride clearance, which accelerated the coronary atherosclerosis.
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  • Studies on the Iron Transport Mechanism of the Human Placenta
    TETSUO TAWADA
    1986 Volume 32 Issue 2 Pages 167-179
    Published: June 10, 1986
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.32.167
    JOURNAL FREE ACCESS
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    Since one-way transport of iron via the human placenta from maternal serum to the fetus has been noted, the localization of transferrin and the dynamics of the iron transport mechanism in the human placental tissue were investigated.The results were as follows. The peroxidase conjugated antibody method was used for localizing transferrin at the microvillous surface of the syncytiotrophoblast, and the specific and reversible attachment of transferrin at this site was recognized. The villous tissue in vitro revealed autoradiographically that radioactive iron is taken up vigorously from 59Fe-diferric transferrin and accumulated into hemosiderin particles neighboring the basement membrane of trophoblast cells, and the colloidal gold technique revealed endocytosis of diferric transferrin attaching on the surface of the syncytiotrophoblast into the cytoplasm and final uptake of transferrin into the lysosomes. Apotransferrin, however, was found to be neither attaching itself to the surface nor incorporaring itself into the cytoplasm. These results suggest that the first phase of the placental iron transport is a specific attachment of maternal transferrin at the site of transferrin receptors of the syncytiotrophoblast plasma membrane, and the second phase is so-called receptor-mediated endocytosis, incorporation of transferrin-bound receptors into the cytoplasm.
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  • Effects of Fat and Bile Acid on Dissolution and Absorption in the Intestine
    -with Special ReferencetoIopanoic Acid-
    TOSHIHIKO IIJIMA, TOMOHISA OSAKA, OSAMU YAMANAKA, TATSUJI KANOH, MASAJ ...
    1986 Volume 32 Issue 2 Pages 180-186
    Published: June 10, 1986
    Released on J-STAGE: November 21, 2014
    DOIhttps://doi.org/10.14789/pjmj.32.180
    JOURNAL FREE ACCESS
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    The dissolution and absorption of iopanoic acid (Telepaque) in the intestine were studied. The subjects were 36 cases of mild diabetes mellitus, who were divided into the following four groups : Group A, Telepaque was administered alone; Group B, Telepaque + 16gm of margarine; Group C, Telepaque + ursodeoxycholic acid (UDCA) 600 mg/day for three days ; and Group D, Telepaque + chenodeoxycholic acid (CDCA) 300 mg/day for three days. The total serum iodine (iodine compounds) levels (iodine level) were determined in each group at two-hour intervals for 12 hours after the administration of Telepaque. Serum iodine compounds values were quantified by using a Thenicon Autoanalyzer after decolorizing the compounds with the ceric sulfate solution. The disappearance curves obtained from the corresponding serum iodine levels revealed that the initial elevations were more pronounced in Groups B, C, and D than in Group A, and the pace of decay of the curve was significantly accelerated in Group C. These findings indicate that dissolution and absorption of Telepaque in the intestine proceed more effectively when fat or bile acid is concurrently used and suggest that the excretion of Telepaque from the liver into bile is promoted by the concomitant use of UDCA.
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