Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 33, Issue 3
Displaying 1-18 of 18 articles from this issue
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Contents
  • Experimental Studies on Intestinal Motility and Metabolism of Bile Acids After Ileocecalectomy
    FUMINORI FUKUSHIMA
    1987 Volume 33 Issue 3 Pages 363-372
    Published: September 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.363
    JOURNAL FREE ACCESS
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    Various kinds of dysfunctions developing following ileocecalectomy have not been adequately elucidated. In recent years, however, it has been implied that bile acids are involved in changes in intestinal motility and the occurrence of diarrhea after ileocecalectomy. In the present study the author attempted elucidate this mechanism in ileocecalectomized dogs. The changes of intestinal motility were observed by a force transducer and X-ray and serum and fecal bile acids were simultaneously determined. The results revealed that intestinal movement was accelerated by ileocecalectomy and the passage time of intestinal cobntents was shortened. On the other hand, total bile acids, DCA and CDCA in the large intestine were increased. This is probably one of the causative factors that acts on the large intestine to accelerate intestinal motility. It is suggested that the destruction of sphincter function and increase in bile acids in the large intestine caused by ileocecalectomy are closely correlated with accelerated intestinal motility as well as the occurrence of diarrhea.
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  • A Diagnostic Study for Detecting Early Esophageal Cancer
    GORO YAMAKI
    1987 Volume 33 Issue 3 Pages 373-383
    Published: September 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.373
    JOURNAL FREE ACCESS
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    Thirty-six cases with 45 lesions of early or superficial esophageal cancer were detect ed in our department between December 1971 and April 1984 including 15 lesions of intraepithelial cancer ('ep' cancer), 8 of intramucosal cancer ('mm' cancer) and 22 of submucosal cancer ('sm' cancer). These early or superficial cancers were morphologically and histologically analyzed, and the following results were obtained : (1) superficial elevated cancers of less than 1 cm were 'ep' or 'mm' cancers whose depth of invasion could be determined by height, (2) srperficial elevated cancers of more than 1 cm were 'mm' cancers, (3) completely flat cancers were 'ep' cancers, (4) superficial depressed cancers of less than 1 cm were 'ep' cancers, (5) the depression of superficial depressed cancer was deeper in an 'mm' cancer than in an 'ep' cancer. The macroscopic features of 'sm' cancers differed extremely from those of 'ep' or 'mm' cancers. Therefore, the following classification should be applied to 'sm' cancers : (1) elvated type, (2) depressed type, (3) mixed type (elevation with depression). In these groups, the depth of invation could be determined by the height of elevation or the depth of ulceration. The majority of patients with early or superficial cancer were asymptomatic. Since there were some patients in the fourth decade, examination should be actively performed in patients 40 years old or over, including asymptomatic individuals. At present, radiology can readily detect an elevated early cancer of more than 1 cm in diameter, regardless of the depth of invation. In the depressed type, an 'sm' cancer of more than 4.5 cm, an 'mm' cancer of more than 4.0 cm and an 'ep' cancer of more than 2.5 cm could be radiologically detected as single cancers. Retrospectively, a depressed 'ep' cancer of more than 1 cm could be radiologically detected in multiple cancer. Early cancers of less than 1 cm were all identified by endoscopy. Therfore, the combined use of radiology and endoscopy is adivisable for detectin of esophageal cancer.
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  • Study on Sinus Rhythm in Patients with Myocardial Infarction during the Post-hospital Phase
    -A Holter Electrocardiographic Monitoring Study-
    TADAO MINAMIZUKA
    1987 Volume 33 Issue 3 Pages 384-396
    Published: September 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.384
    JOURNAL FREE ACCESS
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    Holter monitoring is useful in the management of patients with arrhythmia or ischemic heart disease. Especially, the nature and frequency of premature ventricular contration (PVC) in myocardial infarction (MI) are being extensively investigated. On the other hand, in patients with MI, the effects of the pattern of sinus frequency during sleep on arrhythmia have been clinically studied, attracting much attention in terms of the involvement of the autonomic nervous system in the mechanism of arrythmia. However, it is not clear to what extent the autonomic nervous system is involved in PVC in patients with MI. Therefore, we performed Holter monitoring on 93 patients with old MI and investigated the relationship between the pattern of sinus frequency and serious ventricular arrhythmias by focusing on the trend pattern of the heart rate during sleep. The trend pattern of the heart rate between 2 AM and 6 AM was analyzed and classified into two types, i. e., flat type with almost no variation in heart rate and spike type with a transient increase in heart rate. Among 93 subjects, the flat type was found in 23 and the spike type in 70. With regard to age, the flat type predominanted in patients above the age of 65 years as compared with those with the spike type (p<0.01). With regard to arrhythmia, patients with the flat type showed very few PACs or PVCs, whereas 46 (66%) of 70 patients with the spike type showed serious ventricular arrhythmias (p<0.01). Furthermore, patients with ventricular aneurysm, heart failure or severe coronary artery disease showed serious ventricular arrhythmias and predominantly showed the spike type. These results suggest that, first of all, assessment of cardiac function and coronary atherosclerosis is very important, and investigation of the patterns of sinus frequency is useful in the management of patients with MI in the post-hospital phase.
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  • Clinical and Radiological Studies on Radiological Signs of Ischemic Colitis in Patients with Ulcerative Colitis
    YOSHIKI USUI
    1987 Volume 33 Issue 3 Pages 397-405
    Published: September 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.397
    JOURNAL FREE ACCESS
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    1. Radiological manifestations in 323 examinations of 73 cases of ulcerative colitis (each of whom underwent double-contrast barium enema examination from two to 14 times during follow-up) were carefully reviewed, and radiological signs of ischemic colitis were encountered in four of them (5.5%). All four cases were of the relapsing-remitting type. Three of the four were diagnosed as having involvement of the entire colon, with only left side colon involved in the remaining case. 2. Of ten cases of ulcerative colitis with radiological signs of ischemic colitis, six experienced in the Chiba Cancer Center Hospital, an affiliated institute, were clinically and radiologically analyzed to define their features. Radiological signs of ischemic colitis were often detected in the third and fourth decades, and were more frequently found in females than males. The radiological signs of ischemic colitis were commonly discovered between the transverse colon and sigmoid colon. Some of them were radiologically discovered within a short period, while others were replaced by more severe mucosal alterations of relapsed ulcerative colitis. It is interesting that four of the ten cases were intractable to subsequent medical treatment. 3. Barium-filled views of the splenic flexure as well as doubl-contrast views are required to visualize the radiological signs of ischemic colitis, particularly “thumbprints”.
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  • Prenatal Androgen Exposure, Preoptic Area and Reproductive Functions in the Female Rat
    SATOSHI ITO
    1987 Volume 33 Issue 3 Pages 406-412
    Published: September 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.406
    JOURNAL FREE ACCESS
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    Pregnant rats were injected with 4 mg of testosterone propionate (TP) from days 15 to 22 of pregnancy or a single dose of 4mg TP on day 17 or 21 of pregnancy. Female offspring treated with TP or the vehicle prenatally were sacrificed at 90 days of age. The volume of the cluster of intensely stained neurons in the preoptic area, the “sexually dimorphic nucleus of the preoptic area” (SDN-POA), was found to be affected by prenatal exposure to TP. The effect o f TP on the development of the SDN-POA was most remarkable in the animals treated with a single dose of TP on day 17 of pregnancy, whereas TP injection on day 21 of pregnancy had no remarkable effect. These results suggest that continuous prenatal exposure to TP is not essential for stimulation of the development of the SDN-POA, suggesting the presence of a critical period during which the SDN-POA is most sensitive to the androgen. Although four of 11 females exposed to TP from days 15 to 22 were sterile, the ovarian function of most of the TP-exposed offspring was normal. Furthermore, prenatally TP-exposed females failed to show behavioral masculinization or defiminization. All these females displayed high lordotic response levels and only rarely showed mounting behavior. These results suggest that the absolute volume of SDN-POA dose not seem to be directly correlated with the regulation of the cyclic release of gonadotropins and or expression of sexual behavior.
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  • Perinatal Androgen Exposure, Decreases the Size of the Sexually Dimorphic Medial Preoptic Nucleus in the Rat
    SATOSHI ITO
    1987 Volume 33 Issue 3 Pages 413-417
    Published: September 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.413
    JOURNAL FREE ACCESS
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    The medial preoptic area of the rat is one of the sexually dimorphic regions. The medial preoptic nucleus (MPN) is an intensely stained neuron group in the rostroventral periventricular gray of the preoptic area, and its volume is markedly greater in females than males. In the present study, as one step to elucidate the possible mechanism involved in the development of sexual dimorphism in the MPN, we attempted to determine whether the perinatal administration of testosterone propionate (TP) could influence the structure of the MPN. The pregnant rats were injected subcutaneously with 4 mg of TP on day 17 or 21 of pregnancy. Female offspring from non-injected mothers were injected with 40 p, g of TP. for 7 days from the day of birth. Male offspring not exposed to prenatally were castrated on the day of birth. TP-exposed males and females and neonatally castrated males were sacrificed at 90 days of age. In addition, normal males and females were sacrificed at the same age as the control. The volume of the MPN was significantly greater in the females than in the males, the female volume being 2.2-fold as large as that of the male. However, neonatal treatment of female rats with TP for the first 7 days of life effectively reduced the nuclear volume to a level comparable with that of normal males. These results suggest that the development of the MPN is dependent on the neonatal sex steroid environment. Althogh neonatal castration of males reversed the nuclear volume to a female size, this may be due to the organizational action of endogeneous prenatal androgen exerted before neonatal castration.
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  • EEG Basic Rhythm Analysis Related to Behavior in Medical Students
    SHIGEKO OKADA, REIICHI INOUE
    1987 Volume 33 Issue 3 Pages 418-423
    Published: September 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.418
    JOURNAL FREE ACCESS
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    EEG examinations were executed in 75 healthy medical students (aged 23 to 27, mean 24. 4; 72 males and three females). The results were normal in 55 (73.3%), borderline in 16 (21.3%) and slightly abnormal in four (5.3%). We studied EEG basic rhythm and classified it into five types on the basis of Jung and Koshino's report : 1) regular alpha type, 39 (52.0%); 2) irregular alpha type, 29 (38.7%); 3) slow alpha type, 3 (4.0%); 4) beta type, 3 (4.0%); and 5) low voltage, unstable type, 1 (1.3%). On the assumptions that EEG basic rhythm correlates with individual behavioral pattern and that behavioral pattern may affect one's career, we reviewed the course that each student chose after his or her graduation. It was revealed that students from the irregular alpha group were more likely to choose surgical courses ; however, the result was not statistically significant. We sent a simple questionnaire to all graduates who had received the EEG examination and asked them about their career motivations. We received 41 (56.2%) answers after a month : 79.5% (31) from the regular alpha group and 29.4 % (10) from other groups. The difference was statistically significant (P<0.05). This unexpected difference in response to our investigation may, in part, reflect the psychological or behavioral characteristics of people in each EEG group. The correlation between EEG basic rhythm and behavior is discussed.
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