Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 42, Issue 4
Displaying 1-17 of 17 articles from this issue
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Contents
  • Prophylactic effects on experimental pancreatitis due to prostaglandin and somatostatin analog
    TATSUYA INAYOSHI
    1997 Volume 42 Issue 4 Pages 467-475
    Published: March 25, 1997
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.42.467
    JOURNAL FREE ACCESS
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    The mechanisms of development and progression of acute pancreatitis have been reported to involve escape of pancreatic enzyme from the pancreatic gland and/or decreased blood flow in the pancreatic tissue. Therefore, preventing escape of pancreatic enzyme from the pancreatic gland and/or maintaining the blood flow of the pancreatic tissue might prevent the development and progression of acute pancreatitis. This study estimated the efficacy of pancreatic enzyme inhibitor and vaso-dilator in preventing aggravation of acute pancreatitis. To evaluate the efficacy in caerulein-induced pancreatitis in rats, octreotide acetate (SMS201-995), a somatostatin analog, was used as the pancreatic enzyme inhibitor and beraprost sodium (TRK100), a stabilized derivative of prostaglandin I2, was used as the vaso-dilator to maintain blood flow. Male Wistar rats (approximately 250g of body weight) were administered 20μg of caerulein intraperitoneally to induce pancreatitis. After 2.5μg of TRK100 was orally administered, caerulein was given to 5 rats. Another 5 rats with caerulein-induced pancreatitis were administered 2μg of SMS201-995. Six hours after treatment, pancreatic tissue blood flow, serum amylase, serum elastasel, serum trypsin and drywet ratio of the pancreatic tissue were determined. Moreover, acinar cells were examined by electronanmicroscopy to estimate cell damage using original classification system. The results indicated that TRK100 and SMS201-995 can reduced the severity of acute pancreatitis both serologically and histologically. It is concluded that the inhibition of exocrine to prevent escape of pancreatic enzyme and maintain pancreatic tissue blood flow may prevent the development and progression of acute pancreatitis.
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  • Coronary arterial and myocardial lesions in Kawasaki disease at convalescent stage
    -Assessment by angiography, myocardial biopsy and two-dimensional echocardiography-
    KATSUMI AKIMOTO
    1997 Volume 42 Issue 4 Pages 476-488
    Published: March 25, 1997
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.42.476
    JOURNAL FREE ACCESS
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    To elucidate the long-term prognosis of coronary lesions in Kawasaki disease, coronary angiography, myocardial biopsy and two-dimensional echo cardiography were retrospectively reviewed. Two hundred seventy eight patients, ranging from 1 to 20 years of age were enrolled into this angiographical study. Fifty-nine of the 278 patients underwent more than 2 coronary angiographies. Two hundred twenty cases had coronary arteial lesions.Forty-six had aneurysms and 174 cases had dilatations. All cases of giant aneurysms (≥8 mm in diameter) developed stenosis or total occlusion, while in contrast, 174 cases or dilatation have not progressed. Stenotic lesion in the left coronary artery appeared to be detected during the late convalescent stage more than 10 years after onset, while right coronary lesion appeared to be detected during the early convalescent stage. Endomyocardial biopsy were performed in 11 cases. Of these patient 4 had valve disease and one had a transient hypokinesis of the interventricular septum on echocardiogram, and the remaining 6 patients had aneurysms or dilatation of the coronary arteries. Histological examination revealed that mild mononuclear cell infiltration was found in 5 patients, and moderate infiltration was found in a patient with moderate aortic regurgitation and another with large aneurysm. Fibrosis and disarray were also observed in most patients, even in a case followed for more than ten years since onset. In a few patients cell hypertrophy and degeneration were found. Myocarditis due to Kawasaki disease were not so intense and has no evidence of progression to cardiomyopathy. However, interstitial fibrosis persisted over the longterm. Left ventricular function test demonstrated thatl in 25 patients with coronary lesion, the ESWS-mVcf relationship was in the normal range except for 3 patients with varied ischemic myocardial injury. These 3 patients had previous histories of myocardial infarction. In conclusion, secondary myocardial disease resulting from Kawasaki disease did not develop over the long-term. Because of the appearance of new stenotic lesions, close observation of pediatric patients is needed.
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  • The roles and functions of general hospital psychiatry
    -Clinical data and problems of psychiatric practice in Juntendo University Urayasu Hospital-
    YOSUKE ICHIMIYA, KOU ETO, MASAHIRO TSUJI, TERUO ABE, REIICHI INOUE, CH ...
    1997 Volume 42 Issue 4 Pages 489-493
    Published: March 25, 1997
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.42.489
    JOURNAL FREE ACCESS
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    To study the roles and functions of general hospital psychiatry, we assessed the clinical data and problems of psychiatric practice at Juntendo University Urayasu Hospital. Clinical data was collected for the period between May 1984 and March 1996. During this period, the numbers of out-patients increased annually, and the total number of those patients was 119,895. The number of in-patients referred for consultation liaison service also showed a tendency to increase, especially at the last 3 years. These findings suggest the expanded needs for community psychiatry services and consultation liaison services in our hospital. Both services should play important roles and functions in general hospital psychiatry.
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  • Ocular manifestations of acquired immunodeficiency syndrome (AIDS) in JAPAN
    TOSHIHIKO OHTA, TAEKO UESUGI, HIDEJI HANABUSA, TAKAO MATSUMOTO
    1997 Volume 42 Issue 4 Pages 494-504
    Published: March 25, 1997
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.42.494
    JOURNAL FREE ACCESS
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    Objective : To assess the prevalence of ocular manifestations in human immunodeficiency virus (HIV) -seropositive patients in Japan, and correlations between CD 4 +counts and the presence of CMV retinitis. Materials and methods : We prospectively studied the ocular manifestations in 47 HIV-seropositive patients : Fourteen of them had acquired immunodeficiency syndrome (AIDS), 10 had AIDS-related complex (ARC) and 23 were asymptomatic carriers (AC). Results : Seventy-nine percent of AIDS patients had ocular manifestations, including cotton-wool spots (29%), retinal hemorrhages (36%), Roth spots (7%), cytomegalovirus (CMV) retinitis (43%), papilledema (14%), facial nerve palsy (7%), and retinal vasculitis (7%). We also found ocular disorders in 50% of ARC patients, including cotton-wool spots (20%), retinal hemorrhages (40%) and retinal vasculitis (20%). Ocular disorders were found in 30 % of AC patients, including cotton-wool spots (9%), retinal hemorrhages (22%) and retinal vasculitis (17%). When we used fluorescein angiography (FAG) for 23 HIV-seropositive patients, we detected microaneurysms, telangiectasias, focal nonperfusion and microvascular changes in 80% of AIDS patients, 75% of ARC patients and 36 % of AC patients. There was a correlations between CD 4 +counts and the presence of CMV retinitis. Six of 12 AIDS patients showed CMV retinitis. Subset analysis according to CD 4 +count disclosed that all 6 patients with CMV retinitis had CD 4 +counts of 50cells/mm3 or less. Whereas in patients with CD 4 +counts of 50cells/mm3 or more, none of 8 showed CMV retinitis. The median CD 4 + count for study patients with CMV retinitis was 21.4cells/mm3, in comparison to the median CD 4 +count of 98.9cells/mm3 for patients in the study with no CMV retinitis. Conclusions : These results suggest that ocular findings are also common in AIDS patients in Japan and the prevalence of ocular involvement increases with the increasing severity of the HIV infection. Thus, it is necessary for such patients to undergo a routine series of ophthalmologic examinations. We confirmed the clinical impression that CMV retinitis is a late manifestation of AIDS, and demonstrated an increased risk for patients with low CD 4 +counts.
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  • Successful use of clomipramine DIV in a patient with severe panic disorder
    SHIGEKO SHINOMIYA, YUKO URAKAMI, REIICHI INOUE
    1997 Volume 42 Issue 4 Pages 505-508
    Published: March 25, 1997
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.42.505
    JOURNAL FREE ACCESS
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  • Composite graft repair of the ascending aorta for annuloaortic ectasia. Report of 2 cases
    SHIN YAMAMOTO, SHIRO SASAGURI, ICHIRO HAYASHI, TOMONOBU FUKUDA, YASUYU ...
    1997 Volume 42 Issue 4 Pages 509-514
    Published: March 25, 1997
    Released on J-STAGE: November 18, 2014
    DOIhttps://doi.org/10.14789/pjmj.42.509
    JOURNAL FREE ACCESS
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    Two patients with annuloaortic ectasia underwent composite graft repair of an ascending aorta. (case 1) A 30-year-old man was admitted to the hospital because of type A aortic dissection associated with annuloaortic ectasia. A magnetic resonance image, computed tomography of the aorta demonstrated aortic enlargement with dissection, but revealed no evidence of dissection of the aortic arch. A transesophageal echocardiography demonstrated dissection of the aortic arch. A graft replacement of the total aortic root were performed using hypothermic circulatory arrest with retrograde cerebral perfusion and open distal anastomsis. We reconstructed coronary ostia with Carrel patch, and discontinued the operation without major bleeding. No neurological deficit was found postoperatively. (case 2) A 50-year-old man who had underwent aortic valve replacement for aortic regurgitation was admitted to the hospital because of enlargement of ascending aorta. Preoperative aortogram shows dilated ascending aorta (80mm in diameter). A graft replacement of the total aortic root were performed and we reconstructed coronary ostia with Carrel patch, and completed the operation without major bleeding. There is no complication after the operation.
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