NAKAMURA, T., TAKEBE, K., KUDOH, K., ISHII, M., IMAMURA, K., KIKUCHI, H., KASAI, F., TANDOH, Y., YAMADA, N., ARAI, Y., TERADA, A. and MACHIDA, K. Decreased Counterregulatory Hormone Responses to Insulin-Induced Hypoglycemiain Patients with Pancreatic Diabetes Having Autonomic Neuropathy. Tohoku J. Exp. Med., 1994, 174 (4), 305-315 - Thrirteen patients with pancreatic diabetes caused by calcifying pancreatitis were divided into 2 groups; 5 with diabetic autonomic neuropathy [AN(+) group] and 8 without [AN(-) group]. They were subjected to an insulin-induced hypoglycemic stress test to evaluate their blood pancreatic glucagon, adrenalin, and cortisol responses. When a blood glucose level below 45mg/100ml was defined to be hypoglycemia, all the patients in the AN(-) group exhibited peripheral adrenalin responses, with a significant increase (mean, 19.0 times the basal level) in the blood adrenalin level. Among the AN(+) group, on the other hand, central nervous symptoms became evident rather than the peripheral adrenalin response (the blood adrenalin level hardly exceeded the basal level). With the exception of a single patient, none exhibited responses in the blood pancreatic glucagon levels. Only one patient showed a minimal cortisol response but the remaining 12 reacted normally in the cortisol release. The findings are summarized as follows: in pancreatic diabetes, insulin-induced hypoglycemia causes little change in pancreatic glucagon secretion; when the condition is complicated with autonomic neuropathy, central nervous symptoms develop while the blood adrenalin level hardly increases. These findings indicated that patients with pancreatic diabetes complicated with diabetic autonomic neuropathy have a risk of lapsing into an acute hypoglycemic coma and difficulty in recovering from the hypoglycemic state.
OHKOHCHI, N., SAKURADA, M., KOYAMADA, M., KATOH, H., KOIZUMI, M., HIRANO, T., ORII, T., KANNO, M., TERASHIMA, T., SATOH, K., SATOMI, S., TAGUCHI, Y. and MORI, S. The Importance of Prevention of Sinusoidal Endothelial CellInjury during Cold Preservation of Liver Graft. Tohoku J. Exp. Med., 1994, 174 (4), 317-331 - We investigated adenosine triphosphate (ATP) synthesis, lipid peroxidation, and activities of radical scavenging enzymes in mitochondria, as well as the ultrastructural morphological changes during cold preservation of swine liver grafts (n=6) with either Euro Collins (EC) or University of Wisconsin (UW) solutions. The liver, harvested by a standard procedure, was preserved in one of the solutions at 4°C. The values of the total adenine nucleotide and mitochondrial respiratory control ratio (RCR), an index of ATP synthesis, decreased gradually for up to 24hr during preservation with either of the two solutions and there was no statistical difference between them. Chemiluminescence of mitochondria, an index of lipid peroxidation, in the graft preserved with EC solution or UW solution decreased, and after 24hr there was no significant difference between the two solutions. Activities of radical scavenging enzymes were well maintained in any of the two solutions. Transmission electron microscopy (TEM) findings showed that the sinusoidal endothelial cells were preserved much better with UW solution than with EC solution even after 12hr preservation. We concluded that UW solution, more effective for the protection against injuries of the sinusoidal endothelial cells during cold preservation, leads to better results in clinical transplantation, but this solution has no protective effects on energy production, nor radical scavenging enzyme activities of mitochondria. In the maintenance of liver graft viability, protection of the sinusoidal microcirculatory disturbance is more important than that of the mitochondrial function.
HOSHI, K., TSUKIKAWA, S., OOWADA, M., IGARASHI, K. and SATO, A. Calcaneusand Vertebrae Bone Mineral Density Values and Fracture Threshold. Tohoku J. Exp. Med., 1994, 174 (4), 333-341 - The calcaneus bone mineral density values (BMDs) of healthy Japanese women peaked at 20 to 25 years of age with 435±66mg/cm2 (mean±S.D.), decreased 0.51% on the average every year thereafter until 45 years of age, 1.72% between 45 and 55 years (menopause) and 0.55% thereafter. The vertebrae bone mineral density value peaked at 30 to 35 years of age with 1.06±0.13g/cm2 (mean±S.D.), decreased 0.67% on the average every year thereafter until 45 years of age, 1.23% between 45 and 55 years (menopause) and 0.70% thereafter. Mean -2.0 S.D. of the peak bone mass was considered appropriate as the fracture threshold for both the calcaneus and vertebra, judging from the BMDs of osteoporosis patients.
NAITO, A., HANDA, Y., HANDA, T., ICHIE, M., HOSHIMIYA, N. and SHIMIZU, Y. Study on the Elbow Movement Produced by Functional Electrical Stimulation (FES). Tohoku J. Exp. Med., 1994, 174 (4), 343-349 - Functional electrical stimulation (FES)-induced movements of the upper extremity using the electromyography (EMG)-based stimulation data, which were created on the basis of EMG analysis of elbow flexion and extension in a normal human subject, were examined. As a result of the FES to the elbow flexors and extensors in another normal subject, smooth and reproducible elbow flexion and extension were controlled. This result seems to indicate not only an advantage of EMG-based stimulation data in the FES but also a great potential of FES as a new technique for the functional anatomy of the human extremities.
SADI, A.M., TODA, T., KIYUNA, M., TAMAMOTO, T. and OKU, H. Effect of20-Methylcholanthrene on the Development of Atherosclerosis in LAP Quails. Tohoku J. Exp. Med., 1994, 174 (4), 351-360 - We studied the effect of 20- methylcholanthrene, a carcinogen, on atherosclerosis in the ascending aorta and brachiocephalic arteries of hyperlipidemic and atherosclerosis-prone (LAP) quail. A total of 66 quails were divided into 6 groups and fed the following diets: Group I, basal; Group II, basal+low dose of carcinogen; Group III, basal+high dose of carcinogen; Group IV, basal+0.2% cholesterol; Group V, basal+0.2% cholesterol +low dose of carcinogen; and Group VI, basal+0.2% of cholesterol+high dose of carcinogen. The carcinogen was dissolved in corn oil at 2mg/ml and 4 mg/ml as low and high doses respectively, and was given orally twice weekly. Marked elevation of the serum cholesterol level and significant lipid-rich aortic lesions were observed in all the cholesterol-fed groups after 12 weeks. Although the serum cholesterol level in Group VI was lower than that in Group IV, the severity of the atherosclerotic lesion was greater in the former than in the latter. An immunohistochemical study showed a positive reaction of DBA, PHA and OKM-1 with the lipid-containing cells of aortic intimal lesions.
FUJII, K., HAYAKAWA, T, and KIKUCHI, M. Tumor Induction in MiceAdministered Neonatally with Bis(2-oxopropyl)nitrosamine. Tohoku J. Exp. Med., 1994, 174 (4), 361-368 - ICR mice were given four subcutaneous injections of bis(2-oxopropyl)nitrosamine (BOP) 10, 20 and 40mg/kg body weight, respectively, on day 1, 8, 15 and 22 of age. Animals treated with BOP developed mainly tumors of the lung, liver, nasal cavity, and pancreas. Lung tumors were histologically alveolar cell adenoma or adenocarcinoma at an incidence of 41-100%, hepatocellular adenoma or carcinoma 59-96%, adenoma or adenocarcinoma of the nasal cavity 11-26%, and pancreatic acinar cell adenoma or anaplastic carcinoma 3-7%. No sex difference in response to BOP carcinogen was observed.
OMI, T., KAJII, E. and IKEMOTO, S. The Electrokinetic Behavior of Red BloodCells from a Patient with Tn Syndrome by Doppler Electrophoretic Light ScatteringAnalysis. Tohoku J. Exp. Med., 1994, 174 (4), 369-377 - The Tn syndrome is an acquired form of persistent mixed-field polyagglutination displaying two distinct populations of Tn positive (Tn) and Tn negative (tn) red blood cells (RBCs). We investigated the electrophoretic behavior of RBCs showing polyagglutination from a patient with Tn syndrome by the doppler electrophoretic light scattering (D.E.L.S.) analysis. The mean of zeta potential of normal RBCs from ten individuals was -13.07±0.61mV (mean±S.D.). The content of membrane-associated sialic acid equated with the zeta potential of RBCs. Among the proteases ficin was most effective on the zeta potential of RBCs. The zeta potential of the patient Tn RBCs and to RBCs were -4.73mV and -13.32mV, respectively. Tn RBCs reduced 64.5% of zeta potential compared with to RBCs and formed 48.8%. These results may provide some useful information for classification of Tn syndrome.
HIWATARI, N., SHIMURA, S., TAKISHIMA, T. and SHIRATO, K. BronchoalveolarLavage as a Possible Cause of Acute Exacerbation in Idiopathic PulmonaryFibrosis Patients. Tohoku J. Exp. Med., 1994, 174 (4), 379-386 - In the past 13 years (1980 to 1992), bronchoalveolar lavage (BAL) was performed on 124 idiopathic pulmonary fibrosis (IPF) patients (29 F and 95M, 60±1 years, mean± S.E.) at Tohoku University Clinic and Hospital. Among them, three patients showed acute exacerbation immediately after BAL and died of progressive respiratory failure after 2.5 weeks, 2 months and 3.5 months, respectively, despite intensive care. They were all older patients (79, 74 and 66 years old) and we failed to find any evidence of viral, bacterial or fungus infections either before or after BAL in blood, sputum or BAL fluid samples. Further, all autopsied lungs showed interstitial pneumonia and fibrosis and no evidence of infectious diseases. In contrast, no progressive deteriorations after BAL were observed in 282 patients (122 F and 160M, 48±1 years old) with other pulmonary diseases (sarcoidosis, bronchial asthma, collagen diseases and other interstitial lung diseases), who received BAL during the same period. This suggests that BAL itself sometimes induces a progressive degeneration in IPF patients, especially in older patients.
MORIYAMA, M., HARNISCH, D.L. and MATSUBARA, S. The Development ofGraphic Symbols for Medical Symptoms to Facilitate Communication betweenHealth Care Providers and Receivers. Tohoku J. Exp. Med., 1994, 174 (4), 387-398 -Since there are a variety of communication barriers in health care settings in Japan, a study was designed to improve communication by the use of graphic symbols. At the beginning of this study, graphic symbols were developed to correspond to 26 basic symptoms. Seventy-six subjects voluntarily evaluated the comprehensibility of these symbols: nursing students (n=29), manual sign language interpreters (n=24), hearing impaired subjects with normal (n=10), limited (n=11), and minimal (n=2) literacy abilities. The comprehension by each respondent of each symbol was compared with that of the authors. On the average, numbers of the matching meanings were 24.9±1.36 (mean±S.D.) for students, 24.5±1.77 for interpreters, 23.4±2.22, and 21.5±3.01 for the first two groups of the hearing impaired. Among the 26 symbols, 10 showed high levels of the matching rates (>90%) for all groups. These symbols were considered to be effective alternatives to verbal expression. Further refinements of the graphic symbols were suggested to suppress the differences in interpretation of the remainder of the symbols. During this study, colleagues and subjects suggested cognitive strategies to clarify and enhance the meaning of the graphic symbols such as (a) the subtraction of excessive information, (b) the addition of further information, and (c) the simplification of the setting by minimizing social and cultural bias.