Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
Volume 34, Issue 3
Displaying 1-17 of 17 articles from this issue
Contents
  • MASATAKA SUMIYOSHI
    1988 Volume 34 Issue 3 Pages 344-356
    Published: November 20, 1988
    Released on J-STAGE: November 20, 2014
    JOURNAL FREE ACCESS
    Sixty-one patients with intra -His bundle (BH) block were studied, comparing to patients with A-H and H-V block. Postmortem pathological examinations were performed in 4 patients with BH block. In 160 cases of advanced or complete A-V block, BH block was found in 61 cases (38%) and was generally recognized in elderly women. According to the ECG findings, most patients with BH block showed narrow QRS complex, but the increasing ratio of heart rate was poor during exercise and after the administration of atropine sulfate. Adams-Stokes attack was found in 32 cases (52%) of these patients. The prognosis after implanting pacemakers was relatively satisfactory. Postmortem examination revealed the presence of interruptive lesions in the mid portion and distal His bundle along with proximal bundle branches. In conclusion, BH block was similar to H-V block in clinical severity, and this may explain the fact that the lesion was sometimes extended to bundle branches.
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  • TADAAKI TOKUMARU
    1988 Volume 34 Issue 3 Pages 357-369
    Published: November 20, 1988
    Released on J-STAGE: November 20, 2014
    JOURNAL FREE ACCESS
    Clinical and experimental studies were performed in order to clarify the pathogenesis of bile duct carcinoma and its occurrence in cases of Abnormal Pancreatico-Choledocho-Ductal Junction (APCDJ). Operative specimens of the gallbladder and common bile duct were studied histopathologically in thirty-nine children with congenital biliary dilatation associated with APCDJ. As a result, metaplasia was observed in the gallbladder of five patients and in the bile duct of seven. In addition, hyperplasia occurred in ten patients and dysplasia in the remaining one. Fewer histological changs were observed in children as compared to adults patients. As an experimental animal model of APCDJ, choledocho-pancreatico end to side anastomosis was performed in seven mature dogs and ninty-nine puppies. Histopathological studies of the biliary tract revealed that as the postoperative period became longer, metaplasia and hyperplasia likewise became more prominent. Furthermore, among nine dogs which were sacrificed at five years earlier, papillomatous adenoma occurred in four dogs and biliary stones were found in seven dogs. Cell Kinetics in biliary tract mucosa observed by the use of a monoclonal antibody against bromodeoxyuridine (BrdU) was obviously elevated in the dogs subjected to the long-term follow up. These processes of histological changes in biliary epithelium of clinical and experimental material suggested the possibility of the occurrence of bile duct carcinoma due to the pancreatic juice reflux into the bile duct in cases of APCDJ.
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  • GENJIROH UEDA
    1988 Volume 34 Issue 3 Pages 370-380
    Published: November 20, 1988
    Released on J-STAGE: November 20, 2014
    JOURNAL FREE ACCESS
    In homozygous mice for autosomal recessive gene, lpr or gld, i.e., MRL/Mp-lpr/lpr (MRL/lpr) or C3H/HeJ-gld/gld (C3H/gld) mice, generalized lymphoproliferation of the aberrant L3 T4- /Ly2- T cells associated with systemic lupus erythematosus (SLE) -like autoimmune disease develop. To investigate the relationship between this lymphoproliferative disease and the pathogenesis of SLE, the cell surface phenotypes of the proliferating cells were analyzed with two newly established monoclonal antibodies ALP-1, ALP-2, raised against lpr cells, using two-color flow cytometry analysis. The Lp 1 antigen, recognized by ALP-1, was expressed exclusively on about one-half of the proliferating cells obtained from MRL/ lpr and C3H/gld mice. The Lp 2 antigen, defined by ALP-2, was expressed on approximately 80-90% of proliferating lymph node cells, all the B cells and a population (25 %) of Ly 2+ T cells from normal mice. Based on the distribution of Lp 1 and Lp 2 antigens, the lymph node cells from MRL/ lpr or C 3 H/ gld mice were classified into three subsets, Lp 1 +/Lp 2+, Lp 1-/Lp 2+ and Lp 1 -/Lp 2 All the aberrant 1pr and gld cells with a phenotype of L 3 T 4-/Ly 2 - belonged to either Lp 1+ /Lp 2+ or Lp 1- /Lp 2 +. Since in vitro stimulation with mitogens induced either Lp 1 or Lp 2 antigen on a small population of T lymphocytes from normal mice, these antigens are related to the event of lymphocytic activation. It is possible that the phenotypically unique lpr and gld cells are activated and generated from a very small undefined population of normal lymphocytes. The proliferating lpr and gld lymph node cells contained a significant proportion of L 3 T 4++/Lp 2+ T cells which were rarely found in non- lpr/ lpr or non-gld/ gld mice. It is important to determine whether these cells are activated normal helper T cells or originated from aberrant L 3 T 4-/Ly 2- cells. In addition, studies are now under way to ascertain if these cells are related to autoimmunity.
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  • RYOICHIRO MIYAZAKI
    1988 Volume 34 Issue 3 Pages 381-391
    Published: November 20, 1988
    Released on J-STAGE: November 20, 2014
    JOURNAL FREE ACCESS
    To study the correlation between the development of placenta and its functional changes, immunoflourescent and immuno-histochemical analyses of the distribution of cell- surface antigens of chorionic cells and their age-associated changes were performed, using placentas ranging from 5 gestational weeks to the period of delivery. Monoclonal antibody (MAb) Trop 1 which had been raised against the human chori ocarcinoma cell-line BeWo, reacted with cytotrophoblast, but not with syncytiotrophoblast and non-villous trophoblast, in the first trimester. However, this antigen gradually disappeared after 16 gestational weeks and was negative on the cytotrophoblast of the placentas more than 28 gestational weeks. A very weak expression of Trop 1 was noted on the cytotrophoblast in the case oh intra-uterine fetal death which occurred before 16 gestational weeks. Therefore, Trop 1 seems to be an important functional molecule on the cytotrophoblast at an early phase of pregnancy. The stromal Hofbauer cells (placental macrophages) were also positive for Trop 1. These cells were distinguished by thier morphological characteristics and the expression of HLA class I, HLA-DR and LeuM 3 antigens. Trop 2 antigen, the antigen detected by another MAb raised against BeWo cells, was also distributed only on the cytotrophoblast. The expression of this antigen did not change during the development of the placenta. In contrast to Trop 1 and Trop 2 the transferrin receptor was located on syncytiotrophoblast and partially on the non-villous trophoblast, and was expressed throughout the pregnancy. Thus, this molecule appears to play a role in the basic metabolism of the placenta throughout the pregnancy. Studies of HLA antigens showed that both Class I and Class II antigens were not expressied on the chorionic villous epithels. However, the Class I antigen was positive on the non-villous trophoblast. The lack of HLA antigens on the villous trophoblasts appears to be advantageous against the maternal immune response to the fetus.
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  • KAZUO NOGUCHI, SACHIKO HIROSE
    1988 Volume 34 Issue 3 Pages 392-403
    Published: November 20, 1988
    Released on J-STAGE: November 20, 2014
    JOURNAL FREE ACCESS
    Evidence that genetic factors play important roles in the pathogenesis of systemic lupus erythematosus (SLE) was provided by the findings of an association between major histocompatibility complex (MHC) and human and murine SLE, such as NZB and NZB x NZW (B/W) F1 hybrid mice. Recent studies disclosed that a profound defect in the production of interleukin 2 (IL 2) develops in human as well as murine SLE. To investigate the correlations among the IL 2 deficit, MHC and the pathogenesis of SLE, we established MHC (H-2) congenic NZB, B/W F 1 and NZW strains. These include NZB·H- 2 d/d, NZB·H-2 d/z, NZB·H- 2 z/z B/W F 1·H- 2 d/d, B/W F1·H-2 d/z, B/W F 1·H-2 Z/Z, NZW·H-2 d/d, NZW·H-2d/z and NZW·H-2z/z strains. The results showed that among these steains of mice the deficit of IL 2 production by splenic T cells and the decrease in the number of IL 2 receptor positive T cells were observed only in NZB·H- 2 d/d, NZB·H- 2 d/z and B/W F 1 H- 2 d/zmice. Serum anti-double-stranded (ds) DNA antibodies, a typical clinical SLE feature, were also detected only in these three strains. Therefore, these two SLE features, the defect in the IL 2 production and the synthesis of and-dsDNA antibodies appear to be closely associated with MHC and pathogenetically related. Correlation of the genetic basis between these two SLE features were discussed.
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  • YASUO HAYASHIDA, TAKAO OKADA
    1988 Volume 34 Issue 3 Pages 404-407
    Published: November 20, 1988
    Released on J-STAGE: November 20, 2014
    JOURNAL FREE ACCESS
    The assessment of madical insurance in Juntendo Hospital was studied. Albumin products were first with a total of (44.5%), medicine (injection, drugs except albumin products) second at (27.6%) and biochemical and blood examinations were third with (12.6%) in the assessment. With the exception of albumin products, proteolytic inhibitor, antibiotics, anticancer drugs and brain actibation drugs were assessed with other druds. The assessment of this study questioned the over-prescribing of medications and examination for patients. The essence of medical insurance is based on correct medication and notifiable examinations. Investigation of insurance is hastened smoothly if the reasons and concrete explanations are adequate in the over-issue of the medications and examinations.
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