Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 40, Issue 3
Displaying 1-18 of 18 articles from this issue
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Contents
  • A comparative Study of postoperative nutritional status after pylorus-preserving gastrectomy or B-I gastrectomy.
    YOZO WATANABE, HIDENORI TSUMURA, FUMIO MATSUMOTO, YOSHI MIKAMI, TAKEO ...
    1994 Volume 40 Issue 3 Pages 316-323
    Published: November 18, 1994
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.40.316
    JOURNAL FREE ACCESS
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    We treated early gastric carcinoma located in the M or MA region of the stomach by pylorus-preserving gastrectomy (PPG) to prevent postgasterctomy syndrome. The postoperative nutritional state of patients treated by this technique was compared with that of patients undergoing Billroth-I gastrectomy (B-I G). A total of 20 patients (10 PPG and 10 B-I G), who had undergone surgery at least 1 year previously, were studied. For nutritional assessment, body weight, protein and fat levels, immunological parameters, vitamins, trace elements, and hormone levels were measured. A nutritional index was then calculated from these parameters. We found a significant difference between the two groups in the ratio of standard weight to current weight, midupper arm muscle circumference, prealbumin level, peripheral lymphocyte count, and T lymphocyte count. Patients that had undergone PPG showed a better nutritional status. The nutritional status was good to fair in 70% of the PPG group and 40% of the B-I G group. These findings suggest that PPG is superior to B-I G from the standpoint of postoperative nutrition.
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  • Comparison between stapled and hand-suture esophago-jejunal anastomosis after total gastrectomy
    TAKEO MAEKAWA, TAKANORI HABA, KIYOTAKA YABUKI, SEIKAN RYU, MASAHIKO SA ...
    1994 Volume 40 Issue 3 Pages 324-330
    Published: November 18, 1994
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.40.324
    JOURNAL FREE ACCESS
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    We studied 323 patients who underwent total gastrectomy after 1983 in our institute. In patients (group 1) esophago-jejunostomy was hand-sutured. while in 75 patients (group 2) it was stapled. In each group, we analyzed the duration and amount of bleeding during surgery, the rate of leakage and/or stenosis of the anastomosis, and the length of hospital stay after surgery. The esophago-jejunal anastomosis with autosuture instruments led patient to earlier discharge than hand-suture anastomosis. The rate of leakage was significantly less in the stapled suture group (group 1) than in the hand-suture group (group 2). These results indicate that the esophago-jejunal anastomosis using autosuture instruments reduces stomal leakage, compared to that using hand-suture.
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  • Angiographic measurement of the motor speech area by defining anterior Sylvian arteries
    Yuo IIZUKA
    1994 Volume 40 Issue 3 Pages 331-340
    Published: November 18, 1994
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.40.331
    JOURNAL FREE ACCESS
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    Because of unilateral dominance (laterality) in speech function, the gyral configuration of the area related to this faculty discloses the morphologic differences between the left and right hemispheres to some degree. It is well known facts that the difference is distinct in the planum temporale and sensory speech area (of Wernicke). The motor speech area (of Broca) is considered to occupy the pars opercularis of the inferior frontal gyrus, almost coinciding with Brodmann's cytoarchitectonic area 44. From an angiographic point of view the posterior border of the pars opercularis can be defined by the precentral artery (PC=C in Figs. 1-4) as it passes through the inferior segment of the precentral sulcus. The anterior border of the pars is at the ascending ramus of the Sylvian fissure. Since the prefrontal artery (PF=B in Fig. 1-4) most frequently runs through this ramus, the artery indicates the anterior limit of the pars opercularis. Moreover, the artery can be properly identified on the anteroposterior view, when it runs through the anterior insular space and follows on deeper insular course than other arteries. The third landmark, the orbitofrontal artery (OF=A in Figs. 1-4) follows the horizontal ramus of the Sylvian fissure. On the anteroposterior view, this is likely deep in the fissure and lower in course than the prefrontal artery. We studied both sides of the carotid angiogram in 48 persons without any gross morphologic lesion in the cerebra. Twenty-six subjects were male, and 22, female. Age ranged from 3-years-old through 66 years of age. Forty-six persons were right-handed, one left-handed and one ambidextrous. We measured the distance from the midline the the innermost point of the precentral (C), prefrontal (B) and orbitofrontal (A) artery, respectively. The value of the measurement can be regarded as an inverse image of the depth of each sulcus or ramus of the fissure. That is to say, the deeper a sulcus was, the larger the cortical area established at its depth must be. These values were expressed as the percentage of the width of the ipsilateral hemisphere (Fog. 1-4, M). For all three measurement difference in the value between the left and the right was (Lt.-Rt.=) : +1.04% (for the precentral : C (PC/M)) : +2.2% (for the prefrontal : B (PF/M)) : and +1.37% (for the orbitofrontal : A (OF/M)) in 46 righthanded persons. In the one ambidextrous case, there was recognizable dominance of the right side. One reason for this result is thoght to be that the difference in the motor speech area was not less distinct than that in the sensory speech area. Another point of this investigation focused on the size of each artery and the difference between the right and the left. A larger artery has to have a larger irrigation area.Comparison of the caliber of corresponding arteries as described above suggests a certain difference between the left and right cortical area (Table 2). This comparison is of a practical value when evaluating the extent of the motor speech area in individual cases.
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  • Serological differenciation of HTLV-II infections and its application to survey of the HTLV infections in Asian countries
    YOSHIKO FUKUSHIMA, KATSUTOSHI KOMURO, MITSUO HONDA
    1994 Volume 40 Issue 3 Pages 341-351
    Published: November 18, 1994
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.40.341
    JOURNAL FREE ACCESS
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    Human T-lymphotropic virus type II (HTLV-II) was initially isolated from a patient with hairy cell leukemia in the United States. Recently, it was demonstrated to be infected concomitantly with human immunodeficiency virus type-1 (HIV-1) and human T-lymphotropic virus type I (HTLV-I) in intravenous drug abusers (IVDAs) in the United States. Further more, HTLV-II was present in American intravenous drug abusers by the early 1970s and was introduced into this population before HIV-1. Moreover, HTLV-II infections have been found in the Guaymi Indians in Panama and American Indians in New Mexico. Although HTLV- II has been suggested to be related with a neurological disorder and studied for the effects on HIV-1 -induced diseases, it is not known to be associated with any specific disease, in contrast to HTLV-I. A seroepidemiologic survey was performed to study the spread of retrovirus infections of the HTLVs and HIV in Japan, Vietnam, Thailand and India. In initial experiments, various enzyme-linked immunoassays (ELISA) for HTLV-II, that are commercially available, were used for screening assays. However, they detected false-positive in more than fifty percent of the serum specimens of Japanese hemophiliacs that had been injected non-heated and heated factor VIII or prothrombin complex concentrates, repeatedly. Then, we devised HTLV-II ELISA using the K15 peptide that is specific for HTLV-II, the combination of the ELISA test and PA test for HTLV- I were selected as a primary screening assay for seropositivity for HTLV-I / II because both tests successfully detected seropositives for HTLV-I or HTLV- II. Serum specimens were assayed for HTLV- II infections in Japanese hemophiliacs, and blood donors in Thailand, India and Vietnam. HTLV- II infections have not been detected in the Japanese hemophiliacs or blood donors in Thailand and India. By contrast, approximately one percent of these donors exhibited seropositive for HTLV- II in South Vietnam, but none of them in North Vietnam. Further more, all these individuals seropositive for HTLV- II were detected in IVDAs that were seronegative for HIV-1 or HTLV- I. To confirm the findings, we further studied the HTLV -II infections in classified risk groups; normal healthy controls, children, pregnant women, prostitutes, IVDAs, patients under hemodialysis and hemophiliacs. Interestingly, we revealed the HTLV-II infections exclusively in 60 percent of the IVDAs in South Vietnam. The median of the age of HTLV-II infected IVDAs was 36-40 (45%). These findings show that HTLV-II infection is specifically prevalent in IVDAs in South Vietnam. Collectively these findings show that approximately 60 percent of these IVDAs in South Vietnam (119/200) exhibited seropositive for HTLV- II, showing that HTLV- II is prevalent in IVDAs in South Vietnam.
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