Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 34, Issue 1
Displaying 1-18 of 18 articles from this issue
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Contents
  • Laparoscopy in Gynecological Practice
    SACHIKO TAKASE
    1988 Volume 34 Issue 1 Pages 45-53
    Published: June 20, 1988
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.34.45
    JOURNAL FREE ACCESS
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    The advantages of laparoscopy have been gradually recognized in gynecological practice, but its clinical use has not spread sufficiently to date. In this study, laparoscopy was used 132 times on 129 patients, and the laparoscopic findings were compared with pre-laparoscopic findings to evaluate the usefulness of laparoscopy. There were unexpected findings in 40% of the sterile patients. Some organic changes were found in 75% of the cases of so-called unexplained sterility, and 50% of these patients pelvic endometriosis, In regard to the tubal potency, the rate of concordance hysterosalpingography and chromotubation under laparoscopy was 57.5%. The 38.5% of the patients suspected to have an ectopic pregnancy had a negative finding, and by using laparoscopy, it was possible to determine the location of the implanted embryo. Of the patients suffering from pelvic pain of unknown origin 73.3% had positive findings, (pelvic endometriosis, 3 6.4 %, pelvic inflammmatory disease, 27.3%). The ovaries were classified according to laparoscopic appearance. Ovarian biopsy under laparoscopy was performed, especially on patients whose LH ·RH response pattern was of ovarian and PCO types. In the ovarian type, it was quite difficult to determine whether or not follicular elements, were present, but ovarian biopsy made it possible to determine this by pathological study. The endocronological status of those diagnosed as having the PCO type response by laparoscopy satisfied the diagnostic endocrinological criteria of PCO. In 22.2% of the PCO patients, it was possible to induce ovulation after the ovarian biopsy. In endometriosis the rate of concordance with the pre-laparoscopic diagnosis was 79.3%, while that of unexpected endometriosis was 32.5%. The earlier the progressive stage, the better was the prognosis. These findings show that laparoscopy is a requisite for exact diagnosos of the patient's condition, and its use provides valuable information for making prognoses and choosing the correct method of treatment.
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  • The Fast-Reacting Lysine Residues of F-actin
    KATSUHIKO SUZUKI
    1988 Volume 34 Issue 1 Pages 54-61
    Published: June 20, 1988
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.34.54
    JOURNAL FREE ACCESS
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    We modified the fast-reactive lysine residues of F-actin with maleic anhydride and investigated the interaction of the modified F-actin with myosin. The results are as fellows, 1.After F-actin solution was treated with maleic anhydride, the resulting F-actin (“Maleyl F-actin”) was isolated from the reaction mixture by high-speed centrifugation. The “Maleyl F-actin” obtained was maleylated to the extent of only 1 or 2 moles of lysine per mole of actin. The amount of “Maleyl F-actin” decreased with increasing concentration of maleic anhydride in the reaction mixture. The viscosity of “Maleyl F-actin” was lower than that of unmodified F-actin. 2.The rate and degree of syneresis of actomyosin superprecipitated from “Maleyl F-actin” were higher than those of actomyosin from unmodified F-actin. 3. The activity of myosin ATPase induced by “Maleyl F-actin” was markedly higher than that of actomyosin ATPase from unmodified F-actin. This peculiar activation of the myosin ATPase induced by “Maleyl F-actin” was decreased by chemical modification of the special SH1 residue (SH1) in the myosin molecule with N-ethylmaleimide. These results suggest that the conformation of “Maleyl F-actin” is different from that of unmodified F-actin, inducing a change in viscosity. Therefore, in contrast to unmodified F-actin, “Maleyl F-actin” might combine tightly with the SH1 region of the myosin molecule to increase myosin ATPase activity markedly.
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  • Transplantation of Fetal Cholinergic Neurons into the Brains of Adult Rats
    TETSU KAWAMURA
    1988 Volume 34 Issue 1 Pages 62-71
    Published: June 20, 1988
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.34.62
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    Tissue fragments of the ventral globus pallidus (VP), presumed to contain a number of cholinergic neurons, from fetal rats (18 days of gestation) were transplanted into the lateral ventricle or the neocortex of adult male rats. Three weeks after transplantatin, the brains of the recipients were removed and stained with cresylviolet to verify the survival and location of the transplants. To determine if cholinergic neurons developed in the grafted VP, the grafted neural tissues were examined histochemically and immunohistochemically for acetylcholinesterase (AchE) and choline acetyltransferase (ChAT) respectively. All of the transplants showed an appearance similar to that of normal neural tissue. A number of AchE-positive and/or ChAT-positive neurons were found in the transplanted VP. In the ChAT immunohistochemical study using a monoclonal antibody, the size of the ChAT-positive neuronal cell bodies in the VP grafts was not significantly different from that of the ChAT-positive neurons in the host VP. The shape of these neurons in the grafts was similar to that of the host ChAT-positive neurons in the VP. Several nervefibers of ChAT-positive neurons in the grafts extended into the host brain tissue, suggesting a possible interaction between the host and the tranplants. In the human brain, a severe loss of cholinergic neurons in the nucleus basalis of Meynert (corresponding to the VP in the rat) may be closely associated with the occurrence of Alzheimer's disease. Therefore, the functional reconstruction of the cholinergic input into the cortex by transplantation provides a useful tool for understanding the functions of the nbM-cortex pathway and the etiology of the disease.
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  • The Clinical Study of Relationships Between The Group 1 Pepsinogen (PG1) and Gastric End-Exocrine Activity
    AKIO NOMI
    1988 Volume 34 Issue 1 Pages 72-82
    Published: June 20, 1988
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.34.72
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    The relationship between the serum level of group 1 pepsinogen (PG1) and gastric end-exocrine activity in patients with peptic ulcer were studied in 51 patients (26 normosecretors [group N] with MAO below 20 mEq/hr and 25 hypersecretors [group H] with MAO above 20 mEq/hr) and 37 controls by various loading tests. A positive correlation was obseved between the serum PG1 level and gastric acid secretion during stimulation with betazole hydrochloride and insulin, suggesting the involvement of a cholinergic factor in serum PG1 secretion. Also, gastrin and secretin were considered to be involved in the synthesis and secretion of serum PG1, the former in group N and the latter in both groups N and H.
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  • A Clinical Study of Chemotherapy for Gastric Cancer
    YOZO SASAKI
    1988 Volume 34 Issue 1 Pages 83-92
    Published: June 20, 1988
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.34.83
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    The clinical response to chemotherapy for inoperable gastric cancer depends heavily upon the selection of therapeutic agents and methods in accordance with the performance status and severity of metastasis of each patient. One hundred ninety patients with advanced gastric cancer were treated with cytotoxic agents from September 1969 to May 1984 and the clinical response was evaluated by the criteria of the Japan Society for Cancer Therapy (criteria in evaluating the clinical effect of cancer therapy on solid tumor). Out of 81 evaluable patients, “Partial Response” was achieved in 15 (18.5%), “No Change” in 44 (54.3%) and “Progressive Disease” in 22 (27.2%). The response rate of the regional type of gastric cancer was 30.4%, that of the liver metastatic type was 16.7 %, that of the ascites type was 10.5 % and that of the extra-abdominal type was 0%. The highest response rate was achieved by the combined therapy of fluoropyrimidines and Mitomycin C (MMC) (26.2%). Hematological side effects, however, were more often noted with the combined therapy (43.8%) than with fluoropyrimidines alone (19.2%). The therapeutic results clearly reveal that prolonged survival time was also achieved by the combination of daily oral or anal administration of fluoropyrimidines and intravenous, intraarterial or intraperitoneal injection of MMC. Fluoropyrimidines should be continued as long as possible. To reduce the toxic effect of MMC, one course of treatment shoud be limited to 3 injections when the drug is given intravenously at a weekly dose of 0.2mg/kg and limited to 2 injections when it is given intraperitoneally at a weekly dose of 0.4mg/kg. Administration of MMC shoud be repeated after recovery from hematological side effects, because the majority of the patients recovered from hematological side effects within 1.0-3.7 weeks and the survival time was prolonged in the patients who received more than 2 courses of treatment.The clinical response should be evaluated 2 months after the beginning of treatment, because “Partial Response” was achieved with more than 4 weeks' treatment in more than half of patients with that response.
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  • Reactive Plasmacytosis Complicated with Drug-induced Pancytopenia
    YUKO SUZUKI, DAI-ICHIRO MURATA, YOSHIHISA WAKABAYASHI, NAOKI UEHARA, N ...
    1988 Volume 34 Issue 1 Pages 93-99
    Published: June 20, 1988
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.34.93
    JOURNAL FREE ACCESS
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    A 46-year-old woman was admitted because of fever, pharyngitis, and pancytopenia. On admission, her WBC count was 1000/mm3 with 93% lymphocytes, hemoglobin 6.9g/dl, and platetet count 2.3×104/mm3. Bone marrow revealed hypocellularity with 52.9 % plasma cells, some of which appeared immature and dysplastic. Serum protein electrophoresis showed polyclonal hypergammaglobulinemia. Urine was negative for Bence Jones protein. A punched-out lesion was not seen on the skull X-P. Pulse therapy with methylpredonisolone was started but she did not recover from the pancytopenia, and on the 15th day she died of cerebral hemorrhage with hearniation. Her plasmacytosis and pancytopenia was possibly due to drug, which was given before her admission.
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  • Salivary 17-hydroxyprogesterone in Congenital Adrenal Hyperplasia
    OSAMU ARISAKA, NAOTO SHIMURA, YUKO NAKAYAMA, KEIJIRO YABUTA
    1988 Volume 34 Issue 1 Pages 100-106
    Published: June 20, 1988
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.34.100
    JOURNAL FREE ACCESS
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    Serum concentrations of 17-hydroxyprogesterone (17-OHP) are markedly elevated in untreated or poorly controlled patients with congenital adrenal hyperplasia (CHA) due to a 21-hydroxylase enzyme deficiency. In the present study, we assayed the salivary 17-OHP concentration by specific radioimmunoassay and investigated the correlation between 17-OHP concentration in matched samples of serum and saliva (whole mixed saliva) in 11 patients with CAH and 6 normal controls. There was a close correlation (r=0.93, p<0.01) in 17-OHP levels in 31 matched samples of serum and saliva over a wide range of concentrations. The serum 1 7-OHP concentrations in 11 CAH patients ranged from 1.7 to 247 ng/ml and the corresponding salivary 17-OHP concentrations, from 164 to 15,500 ng/L. The salivary 17-OHP concentations in 6 normal controls ranged from 200 to 300 ng/L. The salevary 17-OHP concentration ranged from 1.8 to 12.0% (5.00±2.39 (mean±SD)) of serum concentration in CAH patients and 5.3 to 8.8% (6.98±1.45) in normal controls. Furthermore, the results of serial (4-8 hour intervals) 17-OHP measurements in matched samples of serum and saliva collected in a 41 hour period from one patient showed an identical pattern of 17-OHP levels. The use of salivary assays and the ease of saliva collectoion in children will permit more detailed monitoring of therapy in patients with CAH.
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