Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 39, Issue 1
Displaying 1-20 of 20 articles from this issue
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Contents
  • Nuclear DNA ploidy pattern in cholecystic cancer
    MASAHIKO SATO
    1993 Volume 39 Issue 1 Pages 45-54
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.45
    JOURNAL FREE ACCESS
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    Using paraffin embedded blocks of resected cholecystic cancer prepared from 39 patients, the nuclear DNA content was measured by a single-cell isolation method through epi-illumination microfluorophotometry to investigate the nuclear DNA ploidy pattern in cholecystic cancer. The nuclear DNA ploidy pattern in 17 patients with cholecystic cancer was classified into a diploid pattern and that in 22 patients an aneuploid pattern. Nuclear DNA ploidy pattern was found to be significantly correlated with lymph node infiltration, perineural infiltration, and lymph node metastasis. The patients in the aneuploid pattern group had a significantly poorer outcome than those in the diploid pattern group. Among the patients demonstrating similar histopathological features, those in the aneuploid pattern group also had a poorer outcome than those in the diploid pattern group. These findings suggested that the nuclear DNA ploidy pattern is effective as parameter of the outcome of cholecystic cancer.
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  • Measurement of class-specific rheumatoid factors (RFs) in serum of patients with rheumatic diseases by ELISA
    MICHIKO TAJIMA, SHIGETO KOBAYASHI, MITSUHIKO TANAKA, HIROSHI HASHIMOTO ...
    1993 Volume 39 Issue 1 Pages 55-64
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.55
    JOURNAL FREE ACCESS
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    Many reports on rheumatoid factors (RFs) in patients with rheumatoid arthritis (RA) have been published, but only a few have examined the class-specificity of RFs in their assays. We established the enzyme-linked immunosorbent assay (ELISA) for the measurement of class-specific RFs. We chose peroxidase-conjugated anti-human antibodies, which did not show non-specific reactivity. For the IgG RF assay, serum pre-treatment with dithiothreitol (DTT) was examined. Although IgM RF was abolished, the level of IgG RF in the serum of 20 patients with RA did not change significantly. Therefore, the serum was not treated in the IgG R F assay. The level of IgM RF was correlated well with that measured by the aggulutination test and immunoturbidimetry assay (TIA) (both p<0.001). There was no correlation among the levels of IgM RF, IgA RF and IgG RF examined with serum specimens from 20 randomly chosen RF positive patients examined by the aggulutination test. The levels of IgM RF, IgA RF and IgG RF were not correlated with the serum IgM, IgA and IgG levels. The serum from 278 patients with RA, 84 with systemic lupus erythematosus (SLE), 44 with progressive systemic sclerosis (PSS), 30 with mixed connective tissue disease (MCTD), 43 with sjögren syndrome (SJS), 39 with poly/dermatomyositis (PM/DM), 38 with Behcet disease (BD), 24 with osteo-arthritis (OA) and 184 healthy volunteers were examined for class-specific RFs. IgM RF, IgA RF, and IgG RF were detected in 65%, 57% and 43% of the patients with RA, respectively, and 3%, 2% and 6% in the serum of the healthy volunteers, respectively. The serum of 38.2% of the RA patients had both IgM RF and IgA RF, that of 24.2% had only IgG RF and that of 11.9% had only IgM RF. The serum of the RA, SjS and SLE patients showed correlation among the levels of IgM RF, IgA RF and IgG RF. However, in the serum from MCTD the level of IgM RF was correlatae with that of IgA RF (r=0.75, p<0.001); and, in hepatic disorders the level of IgA RF was correlated with that of IgG RF (r=0.90, p<0.001). The class-specificity of the RFs in the serum from various rheumatic diseases, and their pathlogical and clinical roles are important in the differentiation of these diseases.
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  • Determination of platelet function in patients with cerebral infarction on antiplatelet therapy
    TADATOSHI KOMIYA, MANABU KUDO, TAKAO URABE, YOSHIKUNI MIZUNO
    1993 Volume 39 Issue 1 Pages 65-72
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.65
    JOURNAL FREE ACCESS
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    Antiplatelet therapy has been shown to play an important role in the prevention of TIA, cerebral thrombosis and ischemic heart diseases. Evaluation of platelet function appears to be important in determining the efficacy of antiplatelet drugs. We recently studied some aggregation inducers and their optimum concentrations, to apply them to evaluation of the major antiplatelet agents, aspirin and ticlopidine. The subjects consisted of 52 patients with cerebral thrombosis, comprising 20 patients on aspirin therapy (81mg/day) and 32 on ticlopidine therapy (12 on 100mg and 20 on 200mg/day). Turbidimetry was used for the measurement of platelet function. Results were as follows : 1) To evaluate the efficacy of aspirin, the 2 μg/ml collageninduced maximum or 5 -min aggregation rate appeared to be useful. The 2μM ADPinduced maximum aggregation rate was useful for evaluation of ticlopidine ; 2) A maximum aggregation rate of ≤60% proved to be an appropriate therapeutic range ; 3) The percent maximum aggregation is generally more useful, since it takes less time to determine than 5-min aggregation. When antiplatelet therapy fails to sufficiently inhibit platelet function, noncompliance, underdosing, and abnormalities of drug absorption and metabolism shoud be considered.
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  • Risk factors for long term mortality after AC bypass surgery
    MICHIO NUKARIYA
    1993 Volume 39 Issue 1 Pages 73-78
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.73
    JOURNAL FREE ACCESS
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    Between 1984 and 1989,806 patients underwent AC bypass surgery in Juntendo hospital with a 1.0% hospital mortality. Among the 798 patients discharged 795 patients were followed with a 99.6 % follow-up rate. The follow-up period was from 4.5 months to 92.8 months with a mean of 53.6 months. The actuarial survival rate was 97% in 3 years, 95% in 5 years, and 91 % in 7 years after surgery and the mortality was 1.2% per year. Seventeen patients (40.4%) died from maligant tumors, 7 patients (6.7%) from cerebro-vascular accidents, 6 patients from cardiac reasons and 12 patients died from other causes. Multiple logistic analysis showed that age of over 65 years, diabetes and poor left ventricular function (ejection fraction less than 45%) were significant risk factors lowering the survival rate and that the use of the internal mammary artery to the left anterior descending coronary artery significantly increased the survival rate.
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  • Adverse reactions to low osmolar iodine contrast media in Juntendo University Hospital
    RYOHEI KUWATSURU, HITOSHI KATAYAMA, MASAHIRO IRIMOTO, TAKAO HIRAIWA, T ...
    1993 Volume 39 Issue 1 Pages 79-87
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.79
    JOURNAL FREE ACCESS
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    Between January 1990 and December 1990, we performed a prospective survey of adverse reactions to contrast media, at one of the institutes of Juntendo University. We collected a total of 3,085 case cards during the period (92.7 % of all examinations). The radiological procedures we investigated were: computed tomography, intravenous urography, arteriography, and venography. Low osmolar iodine contrast media was almost exclusively used (except in 5 cases). The overall incidence of adverse rections was 8.0 %, and there were no severe or fatal reactions. The incidence of adverse reactions was slightly higher in females (9.4 %) than in males (7.1 %). Intraarterial injection caused adverse reactions relatively more often, follwed by regular intravenous injections, and next by bolus intravenous injections. Adverse reactions occurred most frequently during injection, followed by within 5 minutes and next by 5-10 minutes after intravascular administration of contrast media. The incidence of adverse reactions was higher in those who had had a history of allergy or previous reaction. In the allergic patients adverse reactions were observed in a higher frequency. Pretesting had been performed on 60.2% of the patients.
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  • Experimental and clinical study on effects of cholecystectomy for pancreatoduodenal carcinogenesis
    TAKAYUKI UCHIDA
    1993 Volume 39 Issue 1 Pages 88-95
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.88
    JOURNAL FREE ACCESS
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    Histologic observations were performed on the pancreatoduodenal region of a female Syrian golden hamster treated with 10mg /kg body weight N-nitrosobis (2-oxopropyl) amine (BOP) once a week for 6 weeks with and without cholecystectomy. Cholecystectomy was perfomed 5 weeks before the first BOP initiation. Pancreatoduodenal cancer occurred in 10 of the 13 (77%) hamsters receiving cholecystectomy plus BOP injection (group 1), and in 11 of the 14 (79%) hamsters injected with the BOP alone (group 2). Macroscopically, common bile duct dilatation occurred in 7 out of 10 (70%) hamsters in group 1 and 8 out of 11 (73%) hamsters in group 2. Histologically, common bile duct obstruction was induced by common duct cell carcinoma in 5 out of 7 (71%) hamsters in group 1 and by pancreatic duct cell carcinoma in 7 out of 8 (88%) hamsters in group 2 with a significant difference between the groups. In a clinical study, 10 patients who had had bile duct dilatation associated with gallstones or cholecystectomy were found among 50 patients with pancreato-duodenal cancer. Three of them had cholecystectomy, and 2 had a gallbladder out of function. Carcinoma was in the region of the lower bile duct or the ampulla of Vater in all 5 patients. This finding, combined with the observation of the incidence of carcinoma in the common bile duct in hamsters with cholecystectomy in the experimental study, suggests the involvement of the condition of the gallbladder excised or out of function in the incidence of cancer in the lower biliary tract.
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  • Effects of orthotopic liver and fetal liver transplantation in hereditary hyperbilirubinemic Gunn rat
    TADAHARU OKAZAKI, MASUMI NOZAWA, ICHIRO OTSU, SUSUMU MAKINO
    1993 Volume 39 Issue 1 Pages 96-103
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.96
    JOURNAL FREE ACCESS
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    The Gunn rat is an autosomal recessive mutant with hereditary un-conjugated hyperbilirubinemia. Hyper-bilirubinemia is considered to be due to the insufficiency of UDP-glucuronyl-transferase in the liver. Kernicterus is also caused by unconjugated hyper-bilirubinemia. In the Gunn rat, the brain lesion is characterized by marked cerebellar hypoplasia. We performed orthotopic liver (OLT) and intrasplenic fetal liver transplantation (FLT) in the rat model to supply the liver enzymes and studied its effects on bilirubin metabolism. The serum bilirubin level decreased rapidly to the normal level after OLT. Following FLT, the serum bilirubin level decreased significantly but did not reach the normal level. The conjugated bilirubin was also increased in the bile of the Gunn rat with FLT, which suggests that the bilirubin conjugated in the transplanted fetal liver was secreted from the host liver. On the other hand, neither OLT nor FLT was effective in correcting the cerebellar hypoplasia. These findings suggest that not only OLT but also FLT are effective procedures to supply liver emzymes, but further studies are necessary to determine the best timing of OLT or FLT for treatment of associated complications such as cerebellar degenerating changes.
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  • Neurological CPC
    52-year-old male with left hemiparesis and progressive conscioussness disturbance
    Takao URABE, Kazunari KOGAHARA, Toshiji MATUMOTO, Kooichi SUDA, Satoru ...
    1993 Volume 39 Issue 1 Pages 108-116
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.108
    JOURNAL FREE ACCESS
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  • central neurocytoma : A report of two cases
    YOSHIHIDE YASUMA, YOSHIAKI KADOTA, KIYOSHI SATO
    1993 Volume 39 Issue 1 Pages 117-125
    Published: March 20, 1993
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.39.117
    JOURNAL FREE ACCESS
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    Two cases of central neurocytoma are described. Both patients had well-circumscribed masses in the lateral ventricle. Light microscopic examination showed both tumors were composed of small round cells with fibrillary background. Electron microscopic examination demonstrated mature neurite structures within abundant processes of the tumor cells. The correlation between ultrastructural characteristics and biological behavior of the tumor is discussed.
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