Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 33, Issue 2
Displaying 1-17 of 17 articles from this issue
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Contents
  • Neurophysiological Studies on the Mechanism of Intracranial Pressure Waves
    KUNIO TAKAHASHI
    1987 Volume 33 Issue 2 Pages 192-205
    Published: June 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.192
    JOURNAL FREE ACCESS
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    Intracranial pressure waves or Lundberg's ''A'' or ''B'' waves have been recognized since 1960. However, no comprehensive pathophysiology of this phenomenon has been known. Since pressure waves can occur spontaneously, certain endogenous processes may underlie their occurrence. To elucidate the dynamic central mechanisms for eliciting these rhythms, investigations have been done as to whether any close correlation exists between the central monoamine system-the central adrenergic and serotonergic system-and these rhythmic alterations of intracranial pressure (ICP). Some neurons, recorded from the nuclei raphes, the locus coeruleus complex (LC complex), and the nucleus reticularis pontis oralis, fired in phase with the rhythmic ICP changes of the B-wave. On the other hand, the spontaneous discharge of some LC complex neurons were clearly suppressed during the appearance of the A-wave. Activation of LC complex neurons by means of a microinjection of glutamate produced a decrease in ICP, whereas the ICP increased following a microinjection of carbachol into the cholinoceptive pontine area (CPA). Spontaneous discharges of some LC complex neurons were inhibited by electrical stimulation of the contralateral CPA. CPA neurons were antidromically activated by stimulation of the LC complex or the vasomotor center in the medulla. These results suggest that the neuronal mechanism that generates B-waves is probably different from that of the A-wave. On the other hand, the LC complex, the CPA and its vicinities (especially the neuronal connections between them) may provide at least one of the endogenous neuronal basis for the A-wave.
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  • A Cytomorphological Study on the Epithelial Cells of the Biliary Tract
    --SpecialReferencetotheDifferentiationbetweenBenignAtypical Cells and Carcinoma Cells obtained by the Percutaneous Transhepatic CholangiographyDrainage (PTCD) BrushingIVIethod--
    HIDEKI SAKURAI
    1987 Volume 33 Issue 2 Pages 206-218
    Published: June 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.206
    JOURNAL FREE ACCESS
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    Morphological examinations of normal cells, benign atypical cells and carcinoma cells of the biliary tract, obtained by the PTCD brushing method, were performed. Cells examined included those from 23 cases of cancer and 13 cases of benign disease. 1. Cell findings : The predominace of the overlapping of malignant cells over benign cells. Anisocytosis and anisonucleosis were found to be more dominant than normal cells and less than the carcinoma cells. 2. The size of cells and the nucleus : In carcinoma cells and benign atypical cells, the nucleus was larger than in normal cells. The difference between the carcinoma and the beinign atypical cells was not stastically significant. 3. The nuclear contour : In carcinoma and benign atypical cells, the nuclear contour was thickened, and more predominant and irregular in carcinoma cells. 4. Nuclear chromatine : The nuclear chromatine was coarsely condensed in both the benign atypical cells and carcinoma cells, but its distribution was highly irregular in carcinoma cells. 5. The size and number of nucleoli : The number was identical to those found in benign atypical cells and in carcinoma cells. The size, however, appeared conspicuously larger in the carcinoma cells than in the benign atypical cells. The above mentioned conculusions were confirmed by statistics which numerate the various (9) cell findings.
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  • Clinical Study of Patients Who Have Received Emergency Coronary Cinearteriography (CAG)
    JUNSHI TAKAYA
    1987 Volume 33 Issue 2 Pages 219-233
    Published: June 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.219
    JOURNAL FREE ACCESS
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    Coronary cinearteriography (CAG) has been considered a contraindication in cases of an acute myocardial infarction (AMI) or an unstable angina pectoris (U-AP). However, recently the CAG has been applied to such cases for an emergency examination, not only for determining the size of an obstruction and interfering pathogenesis of an myocardial infarction in an acute stage, but also for treating the obstruction by thrombolysis (PTCR). We have utilized an emergency CAG in 43 cases which were diagnosed either suffering from an AMI or an U-AP. Then, in 30 cases out of 34 patients diagnosed as having an AMI, we tried PTCR treatment. Coronary recanalization was successfully brought about in 24 cases (80%), and was unsuccessful in 6 cases (20%). Spontaneous recanalization was observed, in 4 patients. In all cases in which PTCR brought about coronary recanalization, we investigated these cases later, when patients were in their chronic stage, by left ventriculography (LVG). In patients who were successfully treated by PTCR or recovered after spontaneous recanalization, we observed no complications following an AMI, such as serious ventricular arrhythmia or congestive heart failure. The progress achieved with these patients was so much better in obvious contrast to another group who received no PTCR theraphy or had an unsuccessful PTCR respons. In all 9 patients that had an U-AP, we were able to make an early and accurate diagnosis by emergency CAG, and were able to prevent a myocardial infarction from developing. Only one of these 9 patients underwent an emergency A-C bypass graft (CABG) and three were given a semi-emergency CABG, all resulting in good clinical courses, because the surgical treatment could protect them from severe myocardial damage. We thus conclude that an emergency CABG for patients with an AMI or with an UAP is of great importance. We also emphasize that thrombolysis (PTCR) is an immediate life-saving treatment, and a superior method of theraphy to any mechanical support giving left ventricular assistance or the use of intra- aortic balloon pumping (IABP).
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  • Changes in Sympatho-Adrenal Medullary Functions During Aging
    HARUE SUZUKI
    1987 Volume 33 Issue 2 Pages 234-244
    Published: June 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.234
    JOURNAL FREE ACCESS
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    Concentrations of various hormones in peripherally circulating blood have been reported to change during the aging process. For examples, some sex hormones decrease while other hormones, such as prolactin, increase during aging. Catecholamines (CA), secreted from the adrenal glands, are important hormones for regulation of the circulation, the blood glucose level, respiration, and other body functions and it also has been reported that contents of adrenaline (A) and noradrenaline (NA) in the adrenal medulla and NA concentration in the peripheral blood increase during aging, although it is not clear if their secretion rates from the adrenal gland are also incresed. The present experiment was carried to investigate how secretion rates of both A and NA from the adrenal gland would change during aging and, secondarily, if the efferent nerve activity of the sympathetic nerves innervating the adrenal glands would change as well. The experiment was performed on urethane-chloralose anesthetized Wistar rats of different ages between 100 to 900 days after birth. The secretion rate of the adrenal CAs were calculated by measuring both the adrenal venous blood flow rate and the CA concentrations in a adrenal venous blood. Secretion rates of A and NA from the adrenal gland of 100 days old rats were 26.7 ± 2.9 (mean ± S. E.) and 4.0 ± 0.8 ng/kq/min, respectively. Both secretion rates gradually increased after 300 days of age and reached a 2-4 times higher level at 800-900 days of age. Sympathetic efferent nerve activities were measured for each single unit of adrenal sympathetic nerves by using a dissection method with watch forceps. Spontaneous activity in an ''at rest'' condition was 1.4 ± 0.2 impulses/s for 100 days old rats. Their activity increased with an increase in age, similarly to the increases in their CA secretion rates. The present results suggest that adrenal sympathetic efferent nerve activities show increases during aging, resulting in an increase in the secretion rates of both A and NA from the adrenal gland.
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  • 外科治療成績からみたStageIV胃癌切除例の臨床病理学的研究
    MOTOMICHI URABE
    1987 Volume 33 Issue 2 Pages 245-259
    Published: June 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.245
    JOURNAL FREE ACCESS
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    Although Stage IV gastric carcinoma has a poorer prognosis than any other stage gastric carcinomas, we resected a certain number for reduction surgery with immunochemical therapy. In this paper we divided 302 resected cases of Stage IV gastric carcinoma into 15 groups according to the combination of 4 factors in Stage IV (S3, N3-4, P1-3, H1-3) and we studied each factor's influence on the prognosis. 1. Cases with a single factor of StageIV represented 51%. The remaining cases had several factors of Stage IV, 36% with 2 factors, 10% with 3 factors and 3% with 4 factors. 2. According to the increase in the number of factors, the number of large tumors over 8.1 cm occupying 2 or 3 gastric areas increased, and the surgical prognosis was poor. 3. The survival curves for each number of factors, i.e., a single factor, 2 factors, and 3 factors or over, differed significantly, and as the numbers of factors increased, the survival rate decreased. 4. On the basis of these survival curves and a geometric mean of the survival months of each factor, cases S3, N3 and P1 showed a good pronosis and we had 5-year survival cases in these three groups. The prognosis of cases N4, H1-3 and P2-3 remained poor. 5. Due to the effect of the factors of Stage VI, the influence on those with a poorer prognosis was as follows : S3 N3 P1 H3 (N4) P1-3 H2-3. 6. In cases with 3 or 4 factors containing an H-factor of Stage N, the prognosis was very poor; 70 % died within 6 months after operation. Also, a large number of patients died from operative mortality within 30 days. 7. According to the results of these single factors and combined factors, we divided these StageIV gastric carcinoma patients into 3 subtypes; StageIV-a : S3N3P0H0 StageIV-b : --N4P1H0 StageIV-c : ----P2-3H1-3 This classification was useful in estimating the prognosis of Stage IV gastric carcinoma cases, e. g., case IV -c was poorer than case IV-b, and case IV-a had, significantly, the best prognosis. 8. In cases with 3 or 4 factors containing an H-factor, surgical treatment proved of no significance, and we concluded that no indication for surgical treatment of such cases was warranted.
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