KAGAWA, Y., HORIUCHI, T., ITO, T., SUZUKI, Y., HANEDA, K., ISHIZAWA, E., ARAI, S., SEKINO, Y. and. SATO, N. Long-Term Results of Open Heart Repair ofVentricular Septal Defect. Tohoku J. exp. Med., 1987, 151(1), 1-14-Long-term follow-up results of 321 patients who underwent open hert repair of ventricular septal defect in our institute and have lived for more than five years were analyzed using questionnaires. The follow-up period was up to 24 years with an averagr of 12.9 years. The questionnaire mainly concerned the patient's state of health. Beside this, IQ was measured in 52 children, ECG was analyzed in 92 patients and heart catheterization was performed on 21 patients with preoperative severe pulmonary hypertension (PH). From this survey, it was ascertained that (1)no desths resulted from cardiac disorders; (2) physical activity and development were satisfactory in nearly all patients; (3) the scholastic acheivement score was within the normal range in nearly all school children; (4) among 30 live births from 24 adult female patients, two babies with simple cardiac anomalies were found and (5) there remained very few patients suffering from residual PH, residual shunt or conduction disturbances. IQ as tested by individual intelligence tests was within the normal range in all children. On ECG, complete right bundle branch block with left anterior hemiblock was found in 9% and complete atrioventricular block in 7%. Amelioration of PH was achived especially in those who underwent operations in their younger years.
ARAKI, S. and MURATA, K. Factors Affecting the Longevity of Total JapanesePopulation. Tohoku J. exp. Med., 1987, 151(1), 15-24-To clarify the relative importance of social life factors in longevity by age and sex, the authors analyzed the effects of 8 social life factors on life expectancy at birth and at ages 20, 40 and 65 years for males and females in 46 Japanese prefectures. The analysis was conducted twice at five-year intervals during the period of rapid urbanization using stepwise regression analysis after classification of twenty-two variables by factor analysis. The results indicated that urban residence was the major factor for life expectancy at birth for males and females and at ages 20 and 40 years for males; whereas proportions of old and young persons in the population were essential factors for life expectancy at age 40 years for females and at age 65 years for males and females. In addition, in males, proportions of old and young persons in the population also positively affected life expectancy at birth and at age 20 years; employment and high income factor positively affected life expectancy at birth and at ages 20 and 40 years. Unique position of Japan in comparison with Western countries regarding social life factors for longevity is discussed in the light of these findings.
MURATA, K., ARAKI, S. and AONO, H. Assessment of Central and PeripheralNerve Functions in Chain-Saw Operators: A Study of Short-Latency SomatosensoryEvoked Potential and Peripheral Nerve Conduction. Tohoku J. exp. Med., 1987, 151(1), 25-31-In order to clarify the effects of local vibration on the peripheral and central nervous system, peripheral (median) nerve conduction velocities and short-latency somatosensory evoked potentials (SSEP) following stimulation of the median nerve at the wrist were measured in 15 male forest workers in 1986. They had engaged in chain-saw operation for 16-34 (mean 22) years; their working days in 1985 averaged 124 days with a range of 50-203 days. The results indicated significant delays in maximal motor and sensory nerve conduction velocities followed by prolongation of all 4 peak latencies of SSEP up to the sensory cortex of the brain (N9, N13, N20 and P23 latencies) in chain-saw operators; their N9 and P23 latencies were significantly correlated with total working days per year. On the other hand, no significant prolongation of the interpeak latencies of SSEP (i.e., cervico-spinobulbar and central conduction times) was found in the workers. It is concluded that local vibration predominantly affects peripheral nerve conduction; cervico-spinobulbar and central nerve conduction may not be significantly affected.
OTA, H., FUKUSHIMA, M. and MAKI, M. Formation of Polycystic Ovary inMature Rats by the Long-Term Administration of Human Chorionic Gonadotropin. Tohoku J. exp. Med., 1987, 151(1), 33-40-The critical role of high level of serum LH in polycystic ovary syndrome was evaluated in rats by the long-term administration of hCG. Wistar-Imamichi strain mature female rats (age; 12 weeks) which showed at least two consecutive estrous cycles in vaginal smears were daily injected 10 IU hCG subcutaneously from diestrus for 80 days. Conrtol rats were received saline solutions. On the next day after the last administration the rats were killed, and serum hormone levels and histological changes in the ovaries were examined. In 8 of 11 control rats the vaginal smears showed the regular estrous cycles (group 1) during the experimental period. None of the controls exhibited polycystic ovaries. In 19 of 25 experimented rats there were old corpora lutea and degenerated follicles (group 2). The remained animals (n=6; group 3) showed polycystic ovaries and no corpora lutea except one. HCG treatment elevated the serum prolactin and estradiol levels in group 3, but reduced the progesterone level. Thus, it was suggested that the hCG-induced formation of PCO in rats might be able to refer to the pathogenesis in polycystic ovary syndrome.
MIYASAKA, Y. & SAKURAI, M. Characterized Dispersive Wave-Form of EvokedCompound Muscle Action Potential in the Localized Ulnar Nerve Neuropathy. Tohoku J. exp. Med., 1987, 151(1), 41-49-Disorder of the ulnar nerve with continuity around the elbow is known to be a neuropathy produced by long lasting compression, friction or traction. Forty-four patients with clinical diagnosis of ulnar nerve neuropathy were examined by means of motor nerve conduction study and induced electromyography. Compound muscle action potentials (CMAPs) from hand muscle were evoked by stimulating many points proximal and distal to the elbow and analysis of CMAP was performed. In mild grade of nerve lesion, dispersive wave-form with the extension of its duration was elicited by only timulating proximal points to the elbow. It was also found that conduction velocity is delayed only over the short distance across the elbow. Thus an initial stage of nerve lesion has a tendency of dysfunctioning of conductivity restricted in only affected portion. CMAP patterns are classified into four groups in comparison with the progress of clinical signs of the disease. This classification can be utilized for the evaluatioin of the progress of ulnar nerve lesion.
OHNISHI, K., WATANABE, H. and OHE, H. Development of Benign ProstaticHypertrophy Estimated from Ultrasonic Measurement with Long-Term Follow Up. Tohoku J. exp. Med., 1987, 151(1), 51-56-Sixteen cases of benign prostatic hypertrophy (BPH) were followed up by the measurement of the prostatic weightusing transrectal ultrasonotomography over a period of 7 years. In 3 cases (the 'increasing group') the weights increased remarkably, and in the remaining 13 cases (the 'stationary group') did not change very much during the period of observation. The rapid phase of increase in the prostatic weight in the 'increasing group' was observed only in their 6th decade. No special tendency was noticed with regard to age in the 'stationary group'. It is presumed that the enlargement of the hypertrophic prostate might occur rapidly in a short period, probably a few years in the 6th decade or before, and that after rapid enlargement, the weight of the prostate does not change very much.
KOISO, K., KANOH, S., RINSHO, K., NEMOTO, R., ISHIKAWA, H., ISHIKAWA, S., OHTANI, M., NEMOTO, S., TAKESHIMA, H., UCHIDA, K., KONDO, F., SHIMAZUI, T., KIKUCHI, K., KANEKO, S., YOSHII, S., NOGUCHI, R., UMEYAMA, T. and KOSUGI, Y. Urophonographic Studies of the Lower Urinary Tract: A New Approach toUrodynamics. Tohoku J. exp. Med., 1987, 151(1), 57-64-The detection and recording systems for urethral sounds during micturition were developed. This procedure was termed as “urophonography” and its recording as “urophonogram”. Classification of urophonograms was undertaken on the basis of analyzing normal healthy male volunteers, and patients with benign prostatic hyperplasia. Four types of urophonogram were demonstrated. Urophonography was useful for investigation of dysfunctional voiding, and lower urinary tract obstruction. Urophonography will be a new approach to urodynamic investigations.
IMAI, Y., ABE, K., SASAKI, S., MINAMI, N., SEINO, M., YOSHINAGA, K. and TAIRA, N. The Mechanism of Centrally Mediated Cardiovascular Actions of theThree Structurally Different Calcium Antagonists, Verapamil, Diltiazem andNicardipine, in Rats. Tohoku J. exp. Med., 1987, 151(1), 65-80-Centrally mediated cardiovascular effects of the three structurally different calcium antagonists (Ca-antagonists), i.e., verapamil, diltiazem and nicardipine, were studied in rats. In conscious rats, when administered intracerebroventricularly (i.c.v.) in doses of 0.3, 1 and 3μg/kg/min for 30min, all the three Ca-antagonists induced dose-dependent increases in mean arterial pressure (MAP) and pulse rate (PR), whereas nicardipine administered intravenously (i.v.) caused a decrease in MAP and an increase in PR. In anesthetized rats all the three Ca-antagonists in a dose of 3μg/kg/min for 60min i.c.v, significantly potentiated the hypotensive and bradycardic effects of i.c.v. clonidine. Nicardipine, in a dose of 0.3μg/kg/min for 60min i.c.v., attenuated the hypotensive and bradycardic effects of i.c.v clonidine or B-HT 920, an α2-adrenoceptor agonist, in anesthetized rats, whereas it did not modify the cardiovascular effect of i.c.v. angiotensin II or γ-aminobutylic acid in conscious rats. Nicardipine, in a dose of 0.3μg/kg/min for 60min i.v., did not modulate the hypotensive and bradycardic effects of i.c.v. clonidine. 3-Isobutyl-1-methylxanthine (IBMX), a cyclic AMP phosphodiesterase inhibitor, in a dose of 3 μg/kg/min for 60min i.c.v., also attenuated the hypotensive and bradycardic effects of i.c.v. clonidine. Potentiation by the three i.c.v. Ca-antagonists of the hypotensive and bradycardic effects of clonidine would be explainable if their inhibitory effect on Ca-influx is exerted at presynaptic nerve terminals but not at postsynaptic. The mechanisms of the cardiovascular effect of i.c.v. Ca-antagonists still remain to be elucidated but may be independent of a central α2-adrenoceptor mechanism. Dihydropyridine Ca-antagonists like nicardipine are also potent inhibitor of cyclic AMP phosphodiesterase. Since IBMX mimicked the effect of nicardipine, the effect of a low dose of i.c.v. nicardipine in attenuating the hypotensive and bradycardic effects of i.c.v. clonidine may be mediated by inhibition of cyclic AMP phosphodiesterase in the central nervous system.
HANEW, K., GOH, M., SATO, S., SHIMIZU, Y., SASAKI, A. and YOSHINAGA, K. Plasma GH Responses to GHRH and Other Provocative Stimuli in Idiopathic GHDeficiency with or without Abnormal Delivery. Tohoku J. exp. Med., 1987, 151(1), 81-88-Seventeen patients with idiopathic growth hormone dificiency (GHD) were divided into two groups: one has no perinatal abnormalities (group A, n=7) and the other has perinatal abnormalities, i.e. breech delivery and asphyxia (group B, n=10). To see whether there are any differences in hypothalamo-pituitary dysfunctions in the two groups, the pituitary growth hormone (GH) reserve was examined. After 100μg of synthetic growth hormone releasing hormone (GHRH) injection, group A showed a much higher peak values compared to group B (mean±S.E.: 16.1±3.5ng/ml vs. 3.6±0.7ng/ml, p<0.01), although there were no differences in their baseline GH values. In addition, plasma GH responses to arginine and L-dopa, which were performed at the diagnosis of GHD, were also greater in group A than group B (mean peak value: arginine, 3.4±0.5 ng/ml vs 1.8±0.5ng/ml, p<0.05; L-dopa, 3.2±0.7ng/ml vs. 1.3±0.2ng/ml, p< 0.01). There were no significant differences in the bone ages in the two groups, but bone age to chronological age ratio and pubertal development were significantly lower in group B. High ferequency of primipara was observed in group B (7/10) compared to group A (2/7). These results indicate that pituitary GH reserve is much impaired in GHD with abnormal delivery compared to that without abnormal delivery, probably depending on the irreversible hypothalamo-pituitary damages due to prolonged anoxic state during the delivery. Especially, such risks seems to be high when cases of breech presentation are delivered from primipara mothers.
OKAMURA, K., YONEMOTO, Y., HIGASHIIWAI, H. and YAJIMA, A. QuantitativeNBT Reduction Test with or without Stimulation of Peripheral PolymorphonuclearCells from Pregnant Women. Tohoku J. exp. Med., 1987, 151(1), 89-95-We performed the nitroblue tetrazolium (NBT) reduction test to investigate the function of polymorphonuclear cells (PMN) from prenatal, intrapartal, postpartal and nonpregnant women with or without stimulation by phorbol myristate acetate (PMN). The capacity for NBT reduction of PMN was significantly increased in pregnancy, followed by a further increases during labor without any stimulation. On the other hand, when stimulated with PMA, there were no differences between pregnancy and labor in the reactivities of PMNs, although they were stillsignificantly higher than those of nonpregnant women. Kallikrein increased the activity of PMN in an in vitro study, suggesting that it may be associated with the change in PMN function in labor.
OHNEDA, A., KOBAYASHI, T. and NIHEI, J. Glucose-Induced Responses ofInsulin and Gastric Inhibitory Polypeptide in Various Animal Models. Tohoku J. exp. Med., 1987, 151(1), 97-104-In order to clarify the role of gastric inhibitory polypeptide (GIP) in an enteroinsular axis, 19 healthy mongrel dogs were divided into following groups: 5 normal dogs (N), 4 dogs with gastrojejunostomy (GJ), 5 dogs with duodenal fistula (D) and 5 vagotomized dogs (V). Four weeks after the operation glucose was administered orally or intraduodenally in a conscious state. In group D, glucose administration was repeated under atropine injection (A). Glucose-induced response of plasma GIP was exaggerated in all the groups compared with group N. The regression equation reported by Lauritsen and Moody was obtained in each dog from the ratio of plasma insulin to blood glucose and from plasma GIP. The slope of the regression line was elevated in group GJ and reduced in group V. However, groups D and A did not reveal any difference in the slope of the regression line compared with group N. From thepresent study, it might be concluded that the B-values in Lauritsen and Moody's equation indicates the sensitivity of the B cell in the pancreatic islet and that GIP secretion plays an important role in the glucose-induced insulin response even in the conditions with various surgical modifications.
OKABE, M., TANAKA, M., UEHARA, Y., MATSUSHIMA, S., KAKINUMA, M., ABE, F., KOBAYASHI, M., TACHIBANA, N., SAKURADA, K., SAITO, H. and MIYAZAKI, T. Immunological Functions and T-Cell Receptor Gene Rearrangement ofProliferating Lymphocytes in a Case of T Gamma Lymphocytosis withNeutropenia. Tohoku J. exp. Med., 1987, 151(1), 105-115-A case of Tγ lymphocytosis with neutropenia is presented. The patient showed mild lymphocytosis, splenomegaly, anemia, neutropenia and recurrent infections without progression for 15 years. The expanded lymphoid cells were morphologically large granular lymphocytes (LGL), had receptors for both sheep red blood cells and IgG-Fc portion and were positive for OKT3 and 8 antigens. They displayed ADCC activity, whereas they showed low responses to T-cell mitogens and deficient NK activity. They showed neither suppressor activity on antibody production by B-cells nor suppressor activity on CFU-C formation. The DNA isolated from the expanded cells of the patient showed T-cell β-chain (Tβ) gene rearrangement, indicating monoclonality of the proliferation. This finding supports that the proliferation of T8 lymphocytes in the present case is neoplastic rather than reactive, regardless of the benign clinical course.
DOHKITA, S., NISHIMOTO, T. and MORITA, T. Noradrenaline Content inCanine Lower Urinary Tract Tissue. Tohoku J. exp. Med., 1987, 151(1), 117-119 -To examine the distribution of sympathetic nerve fibers in the lower urinary tract, the noradrenaline content was measured in the urinary bladder dome and base, and proximal and distal urethra of the male and female dogs, using high pressure liquid chromatography-electrochemical detection (HPLC-ED). The noradrenaline content was the highest in the proximal urethra and the lowest in the urinary bladder dome in both sexes. The noradrenaline content of the proximal urethra was significantly higher in the male than in the female, whereas the content of the urinary bladder base and the distal urethra was lower in the male than in he female. These data suggest that sympathetic innervation is the richest in the proximal urethra in the lower urinary tract and that there is a sex difference in the sympathetic innervation in the lower urinary tract.
KANOH, T., OHNAKA, T., UCHINO, H. and FUJII, H. The Outcome of IdiopathicBence Jones Proteinur. Tohoku J. exp. Med., 1987, 151(1), 121-126-The authors studied two patients with idiopathic Bence Jones proteinuria (BJP) that fulfill all the criteria proposed by Kyle and Greipp. None had evidence of overt multiple myeloma, of its variants, of primary systemic amyloidosis, or of other lymphoid tumors. In a patient with kappa type idiopathic BJP an elevation of a labelling index was found when an evolving myeloma developed 2 years later. The other had benign lambda type BJP until he died of bronchogenic carcinoma after 14 years. In most of patients with idiopathic BJP overt multiple myeloma or systemic amyloidosis have developed after a long period. An elevation of labelling index in the course of illness is expected to be a premonitory sign for malignant transformation. Idiopathic BJP may be characterized by less nephrotoxicity or amyloidogenicity of Bence Jones protein synthesized as well as a slow growth rate of tumor cells.
KITAOKA, S., SUZUKI, H., SATO, T., NUMAZAKI, Y., KONNO, T. and ISHIDA, N. Failure in Chymotrypsin Enhancement of Human Rotavirus Infectivity. Tohoku J. exp. Med., 1987, 151(1), 127-128-Effects of α-chymotrypsin on human rotavirus infectivity and hemagglutination activity were investigated using the KUN strain which was grown in the absence of trypsin and nonifectious. No activating effect of the enzyme on the virus infectivity was found, while HA titers of the virus rapidly decreased after exposure to the enzyme.