岡山医学会Acta Medica Okayama0030-155810341991近年における薬毒物の検出された司法解剖例について455462ENFumioMoriyaRyoNanikawaYoshiakiHashimotoPoisons and drugs other than alcohol and CO were detected in 17 of all judicial autopsy cases in the Department of Legal Medicine, Okayama University Medical School during the last 12 years. We report 7 cases from the forensic toxicological viewpoint. 1) lethal overdose of Sedes A, 2) fatal poisoning due to biperiden, thioridazine and nitrazepam taken simultaneously, 3) fatal DDVP poisoning, 4) fatal paraquat poisoning, 5) hypoxic death by inhalation of liquefied petroleum gas, 6) fatal shock induced by sulpyrine, and 7) fatal shock induced by ketoprofen.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991Poor R Wave Progression 例における陳旧性前壁梗塞の鑑別―体表面心臓電位図による検討―445454ENKeikoIharaThe clinical usefulness of the body surface maps (maps) to discriminate old anterior myocardial infarction (OAMI) in patients whose ECG showed poor R wave progression (PRWP) was examined. The maps of 60 patients with PRWP, including 33 cases of OAMI and 27 without myocardial infarction (non-MI) were recorded. The multivariate stepwise discriminant analysis elucidated that 5 leads (G4, C3, J5, B3, A5) of the QRST area map would contribute to the discrimination of OAMI from non-MI, and the the formula z=-6.0×G4+26.8×C3+9.1×J5-14.0×B3-9.0×A5-1.1(unit : 0.1mVS), using these parameters two groups were separated with a sensitivity of 90.9% and a specificity of 96.3%. The discriminating performance using 5 leads (G4, H2, H4, L6, M5)of the QRS area map and 5 leads (G5, G2, H4, L5, M5) of the Q20 map gave a sensitivity of 90.9%, and 93.9%, and specificity of 96.3%, and 92.6%, respectively. Furthermore, for formula was applied to 26 new consecutive patients with PRWP for evaluating this formula. The indicies obrained from the QRST area map gave the best results, and provided a sensitivity of 85.7% and a specificity of 100%. In the pattern of the QRST area map, the existence of the regions less than-20μVS can fairly identify the OAMI (sensitivity 87.9%, specificity 85.2%). These findings suggest that the mathematical models obtained from the result of map analysis, especially QRST area maps, are useful to discriminate OAMI among the cases with PRWP.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991気管支喘息における体液因子に関する研究 第2編 補体系C3 (β(1c/1A)), C4(β(1E)) 値の変動について435444ENKenIshibashiSerum C3 and C4 levels were measured in 23 healthy subjects and 105 patients with bronchial asthma, by an immunodiffusion method using M-Partigen Plates. The serum levels of C4 were significantly increased in patients over 60 years old compared to the healthy subjects.
The levels of C3 were significantly higher in male cases than in female cases with bronchial asthma. The serum levels of C3 and C4 in asthma patients with infectious type, in severe cases and in cases with steroid therapy were within the normal limits during non-attack periods, but significantly increased during attack periods.
In asthmatic patients with mixed and infectious type, and in mild and severe cases, a significant correlation was observed between the serum levels of C3 and C4 during their non-attack periods.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991気管支喘息における体液因子に関する研究 第1編 血清糖蛋白 (α(1)-Antitrypsin, α(1)-Acid glycoprotein) の変動について419434ENKenIshibashiSerum α(1)-Antitrypsin (α(1)-AT) and α(1)-Acid glycoprotein (α(1)-AG) levels were measured in 34 healthy subjects, 167 patients with bronchial asthma and 82 cases with other respiratory diseases. The serum levels of α(1)-AT were significantly increased in patients over 40 years old and the levels of α(1)-AG were significantly higher in patients over 50 years old compared to the those under 50 years old.
The serum levels of α(1)-AT and α(1)-AG were significantly more increased in asthmatic patients with mixed and infective type during asymptomatic periods than in healthy subjects.
The levels of α(1)-AT were significantly higher in patients with mild and moderate asthma than in healthy subjects. The levels of α(1)-AG were also significantly higher in mild and severe asthmatic patients than in healthy subjects.
Patients with severe asthma showed more increased levels of α(1)-AT during attack periods compared to that during non-attack periods. The levels of α(1)-AT and α(1)-AG in asthma patients with steroid therapy were within normal limits during the non-attack periods, but significantly increased during the attack periods. In asthmatic patients with mixed type, infectious type, severe type and steroid therapy, a correlation was observed between the serum levels of α(1)-AT and α(1)-AG during their attack periods.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991高知県の西南地域と高知市におけるコガタアカイエカの季節的消長と日本脳炎患者発生状況411418ENSawakoMatsuzakiAdults mosquitoes of Culex tritaeniorhynchus were collected by light traps in a pigsty at Kochi City located in the central Kochi Prefecture and that at Tosashimizu City located in the southern Kochi Prefecture from 1965 to 1972. A marked difference was observed in seasonal fluctuation of mosquito population between the two sites of collection. During the period of observation, the incidence of Japanese encephalitis patients fluctuated in parallel with the average population of mosquitoes collected from June to September. The first incidnece of Japanese encephalitis patients in Kochi Prefecture generally starts from south-western Kochi Prefecture including Tosashimizu City and gradually moves north. This is coincident with the trend observed in the appearance of the first mosquito population in these area.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991気管支喘息におけるリンパ球機能に関する研究 第2編 気管支喘息における suppressor cell 機能の検討399409ENShoTakadaCellular immunity in bronchial asthma has become essential for the regulation of various allergic reactions in the asthmatic attack. The function of peripheral blood lymphocytes of asthmatic patients was examined by the concanavalin A (Con A) induced suppressor cell assay. The suppressor activity of lymphocytes in mitogen-induced blastogenesis was shown to be decreased in patints with atopic and intractable asthma in comparison with the normal control. The suppressor activity in mite antigen induced lymphocyte blastogenesis was also decreased in patients with atopic asthma. Furthermore, the decrease of ConA induced suppressor activity correlated with the increase of serum IgE level in patients with atopic asthma. These findings indicate that the decreased suppressor cell activity is part of the mechanism of attack and may play an important role in the pathogensis of bronchial asthma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991気管支喘息におけるリンパ球機能に関する研究 第1編 気管支喘息におけるBAL 液中並びに末梢血中リンパ球の吸入抗原に対する幼若化反応の検討387397ENShoTakadaVarious antigens such as mite and fungi have been known to provoke bronchoconstriction in patients with bronchial asthma. The allergic mechanisms of asthmatic attack induced by these antigens were analyzed to clarify the role of cellular immunity in the pathogenesis of bronchial asthma. Mite and Candida antigens were applied to lymphocyte blastogenesis in asthmatic patients. Both lymphocytes in bronchoalveolar lavage fluid (BALF) and in peripheral blood of asthmatic patients responded significantly to mite and Candida antiten. Furthermore, BALF lymphocytes of patients with non-atopic and intractable asthma showed higher responses against Candida antigen than those of patients with atopic and non-intractable asthma, while peripheral blood lymphocytes showed a higher response against mite antigen in patients with atopic and non-intractable asthma. These findings indicate that lymphocytes in lugns sensitized with Candida antigen might play an important role in the pathogenesis of non-atopic and intractable asthma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991特発性血小板減少性紫斑病 (ITP)に関する臨床的研究 第2編 ITP の治療効果の解析とステロイド難反応性ITPに対するコルヒチン療法の意義について373386ENNaokazuTsurumiClinical effects of steroid and colchicine therapy in 49 patients with ITP especially the refractory cases were evaluated in comparison with splenectomy and danazol therapy.
There were 27(55%) steroid resistant patients who could not maintain platelet counts of 5×10(4)/μl with prednisolone doses of less than 10mg/day. Among the 16 steroid resistant patients treated with colchicine, there were 3 patients with complete remission and 3 others who had good to excellent response, that is, 6(37.5%) improved overall. This therapy was more effective than splenectomy (33.3%) and danazol (25%). Colchicine was did not effective in patients who did not respond to prednisolone, but was useful when patients showed at least a transient rise of the platelet count with prednisolone. In many cases, a response to colchicine was seen after a month, and in the patients who failed to show a rise in the platelet count after 2 months of colchicine therapy, no benefit was seen even when the therapy was continued. Colchicine is advantageous in the treatment of the steroid resistant ITP over the immunosuppressive agents or high-dose γ-globulin that are expensive and produce only a transient rise in the platelet count.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991特発性血小板減少性紫斑病 (ITP)に関する臨床的研究 第1編 ITP の予後と血小板表面関連免疫グロブリン platelet associated IgG (PAIgG) との関係359371ENNaokazuTsurumiPlatelet associated IgG (PAIgG) levels in 45 ITP patients were measured by the single radialimmunodiffusion (SRID) technique to determine whether PAIgG could be used as a prgnostic index for ITP. The PAIgG levels in ITP patients were significantly higher than those in normal controls and showed an inverse correlation with the platelet count (Y221.9-13.4X,p<0.01). The PAIgG level decreased significantly after the first course of steroid therapy in both the steroid responsive and the steroid resistant ITP patients. However, in the clinically stable period, the PAIgG level in the steroid resistant patients remainde significantly higher than in the responsive patients (p<0.005). Although the PAIgG level after splenectomy decreased significantly(p<0.05) in the patients with complete remission, it remained remained significantly higher (p<0.05)in the nonresponders. Maximum platelet count after therapy divided by the number of days elapsing from the time of therapy to the day showing the maximum platelet count, was significantly higher in the responders.
The PAIgG level in the stable period after steroid therapy, and the rate of increase in the platelet counts in the early period after steroid therapy were suggested to be useful as indices of the prognosis of ITP.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991過敏性肺臓炎の病態に関する研究 第2編 過敏性肺臓炎患者における沈降抗体に関する検討349358ENKohMakimotoThe presence of percipitating antibodies has been recognized to be essential for the diagnosis of hypersensitivity pneumonitis, although the mechanism of this antibody formation is still obscure. Precipitating antibodies were examined in patients with various respiratory disease including hypersensitivity pneumonitis. Patients with hypersensitivity pneumonitis had more precipitating antibodies than patients with bronchial asthma, PIE syndrome and other fibrotic lung diseases. Furthermore, asymptomatic family members of patients with hypersensitivity pneumonitis living in the same environment were shown to have few precipitating antibodies as a normal control. The presence of polluted air containing an antigen such as fungi is nescessary but not enough for the antibody formation. These findings suggest that the high responsiveness of the immune system of the respiratory tract would be important as well as the existance of contaminated air for the pathogenesis of hypersensitivity pneumonitis.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991過敏性肺臓炎の病態に関する研究 第1編 実験的過敏性肺臓炎における免疫学的並びに病理組織学的検討337347ENKohMakimotoHypersensitivity pneumonitis is well known as an allergic respiratory disease although the exact pathogenesis is still in controversy. An experimental animal model was established with Micropolyspora faeni (Mf) as the antigen, and the various immunological mechanisms were evaluated. Transtracheal challange of Mf antigen in guinea pigs sensitized with Mf antigen showed granulomatous pneumonitis compatible with hypersensitivity pneumonitis in humans including the precipitating antibody. The cellular responses in the lungs of animal model was examined with bronchoalveolar lavage (BAL) and the increase of total cell count and lymphocyte percentage were shown to correlate with the degree of alveolitis. Lymphocytes in BAL fluid of sensitized guinea pigs were shown to repond to Mf antigen specifically. Several characteristics of hypersensitivity pneumonitis were clearly shown in this animal model. Although the actual pathogenesis in humans is still obscure. this model could be useful in the evaluation of the patients with hypersensitivity pneumonitis.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991Methyl isobutyl ketone の代謝と生物学的モニタリング 第2編 Methyl isobutyl ketone 暴露作業者の尿中代謝産物327335ENNaomasaHirotaA field study on the metabolites of methyl isobutyl ketone (MIBK) in the urine of 20 workers who were exposed to mixed solvents containing MIBK, and in that of a subject exposed to pure MIBK with 3 separate control subjects were observed. One of the urinary metabolites, 4-methyl-2-pentanol (4M2P) was identified by gas chromatography-mass spectrometry only in the urine of workers exposed to MIBK. Time-weighted average concentration of the mixed solvents for 8 hours were as follows ; MIBK 21.9±15.1 ppm (m±SD), toluene 18.3±8.9 ppm, ethyl benzene 9.6±4.6 ppm, xylene (total) 18.9±12.5 ppm. The regression equation between MIBK concentration X (ppm) in air and 4M2P concentration Y (mg/g creatinine) in the urine was : Y=25X-10.25. Its correlation coefficient was 0.63. Thus the urinary concentration of 4M2P corresponding TLV (Threshould Limit Values : 50ppm) of MIBK was 2.61 (mg/g creatinine). In a subject exposed to pure MIBK, the time-weighted average concentration of MIBK for 6 hours was 42.3ppm and 4M2P concentration in the urine was 0.42 (mg/g creatinine).No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991Methyl isobutyl ketone の代謝と生物学的モニタリング 第1編 Methyl isobutyl ketone 腹腔内投与ラットの呼気･尿中 methyl isobutyl ketone の排泄及び尿中代謝産物315325ENNaomasaHirotaRats were injected intraperitoneally with 100mg/kg, 200mg/kg and 300mg/kg of methyl isobutyl ketone (MIBK) in a single dose, and the amount of MIBK in the expired air and in the urine were studied. One of the metabolites was identified as 4-methyl-2-pentanol (4M2P) in the urine by gas chromatography-mass spectrometry. The concentration of MIBK in the exhaled air attainend its maximum within 0.5 hour. Thereafter it decreased with a half life of 0.6 hour, and 41.1±8.7 (m±SD) % of the total amount injected was exhaled within 24 hours. The concentration of MIBK in the urine attained its maximum within 3 hours after injection. Then it decreased with a half life of 1.8 hours and 0.19±0.11 (m±SD) % of the total amount administered was excreted in 18 hours. The concentration of 4M2P in the urine attained its maximum in 3-6 hour and decreased gradually thereafter. Its half life was 3.2 hours and 0.31±0.18 (m±SD) % of the total amount was excreted in 12 hours.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991日本人ヒポカタラセミア, マウスヒポカタラセミア, マウスアカタラセミアの血球カタラーゼの比活性度305313ENYasuhitoFujiiBlood catalase was purified by CM-cellulose followed by DEAE-cellulose and Sephadex G-150 from blood of Japanese individuals. Rabbit was injected with purified blood catalase emulsified wiwth Freund complete adjuvant. Blood was taken after 6 injections, serum was separated as anti-Japanese blood catalase rabbit serum, and was used for the immunotitration of blood catalase from hypocatalasemic and normal Japanese.
Liver catalase was purified twice from the ammonium sulfate fraction of mice liver supernatant by using the same Sephadex G-200 column. In the same way as for humans, the rabbit was immunized and serum was taken as anti-mice liver catalase tabbit serum, and was used for the immunotitration of blood catalase from acatalasemic, hypocatalasemic and normal mice. Specific activity of catalase in the blood of the hypocatalasemic Japanese was determined by immunotitration. That activity was the same as that of catalase in the blood of normal Japanese individuals. In contrast to this, the specific activity in the blood of hypocatalasemic mice was lower than that of normal mice. Specific activity of residual catalase in the blood of acatalasemic mice showed the lowest value among the activities in the blood of normal, hypocatalasemic and acatalasemic mice.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991心筋虚血・再灌流障害における過酸化脂質の動態と h-SOD 投与効果293303ENEijiIkedaTo clarify the role of free radicals and the efficacy of human superoxide dismutase (h-SOD) on cardiac ischemia/reperfusion injury, adult mongrel dogs were placed on a cardiopulmonary bypass (CPB). Aorta was cross clamped for 120 minutes and crystalloid cardioplegic solution was administered into the aortic root every 30 minutes. Sixteen dogs were divided into the control group and non cross clamped group (XCL(-)group). They were placed on total CPB for 130 minutes without an aortic cross clamp.
The control group showed higher thiobarbituric acid reactive substance (TBARS) release from heart in early reperfusion phase (P<0.05), and suppressed recovery of cardiac index (CI) and max dp/dt at 60 minutes after reperfusion (P<0.01 and P<0.05, respectively) than XCL (-) group. Eight dogs were administered saline and 32 dogs were administered saline and h-SOD into the aortic root just before reperfusion. Dogs, administered h-SOD, were devided into four groups by the dese of h-SOD, group I : 1mg/kg, group II : 3mg/kg, group III : 10mg/kg, and group IV : 20mg/kg. Between control and saline groups, no significant difference was found. Groups I and II showed suppressed TBARS release from the heart in the early reperfusion phase than the control group (P<0.01 and P<0.05, respectively). Groups II and III showed higher recovery of CI at 60 minutes after reperfusion than the control group (P<0.01 and P<0.05, respectively). In conclusion, significantly higher TBARS was released from the heart and recovery of cardiac function was suppressed in cardiac ischemia/reperfusion injury. The h-SOD administtation was effective to protect the heart from cardiac ischemia/reperfusion injury.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991ラット脳内 σ 受容体の薬理学的特異性に関する研究―とくに抗精神病薬との抗虚血剤の作用について―281292ENYoshifumiZushiPharmacological specificity of several classes of drugs such as antipsychotics and antiischemic agents was assessed for σ receptors labeled with [(3)H] haloperidol. Specific binding of [(3)H] haloperidol in the presence of 25 nM spiperone was saturable and high affinity )Kd=1.96±1.31 nM, Bmax=2.37±0.27pmol/mg of protein;n=8). Among the 29 antipsychotics tested in inhibition studies, bromperidol and haloperidol were the most potent inhibitors (Ki=0.9nM, 1.0nM, respectively). The conventional antipsychotics moperone, timiperone etc. and the novel promising drugs YM-09151, Y-516, BMY-14802 and remoxipride potently inhibited [(3)H] haloperidol binding with the Ki in the range of low to moderate nanomolar. On the other hand, among the other 27 drugs tested, the antispasmodics eperisone and tolperisone, the antiischemic agents ifenprodil, the Ca(2+) antagonist flunarizine and cinnarizine, and the antitussives carbetapentane, cloperastine and dextromethorphan, were especially potent inhibitors. These results, taken together with the evidence that the antiischemic agents ifenprodil and dextromethorphan antagozine NMDA responses and NMDA receptor complex is a possible site of action for neuroprotective agents, strongly suggest that σ receptors may be potential sites of action for antiischemic as well as antipsychotic drugs, i.e., σ receptors mediate the neuroprotective effects of certain antiischemic agents by affecting the NMDA receptor complex.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991単純ヘルペスウイルス感染細胞表面に発現するFc-レセプターによる感作赤血球吸着反応―微細形態学的ならびに細胞生物学的考察―267280ENZeng-LiangBaiAdsorption of sensitized sheep erythrocytes to FL cells infected with HSV-1 was studied biologically and morphologically. Almost 100% of the FL cells at a late stage of infection (i.e. 23 hrs) were positive for the appearance of HSV-1 gC antigen, while about 86% of them had hemadsorption (HAD) activity. To elucidate why all the infected cells do not show HAD activity, FL cells at the similar stage of infection were examined by high-resolution scanning electron microscopy and also by immuno-scanning electron microscopy. When infected cells were treated first with peroxidase-antiperoxidase (PAP) rabbit IgG and then with goat anti-rabbit IgG Iabeled with colloidal gold, the surface of all the cells were clearly tagged with colloidal gold particles. Morphological observations of HAD revealed that many microvilli adhered to the surface of erythrocytes.
Thus, in addition to the expression of HSV-induced FcR on the surface membrane of infected cells, which is prerequisite for HAD, microvilli play an essential role on the appearance of this phenomenon.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991イヌの完全全脳虚血後の脳障害に及ぼすSMA-SOD の効果に関する実験的研究257266ENYoshimasaTakedaThe effects of stylene maleinic acid butyl ester superoxide dismutase (SMA-SOD) on the brain damage induced by ischemia were studied in dogs. Eighteen minutes of cerebral ischemia was produced by clamping the ascending aorta with aorta-atrial and aorta-femoral vein bypass circuit. SMA-SOD(10mg/kg) was administered just after the initiation of recirculation. Dogs were divided into, control group and SMA-SOD group. In each group, cerebral blood flow (CBF) and intracranial pressure (ICP) were measured for 7 hours after ischemia, and neurologic outcome was evaluated up to 7 days after ischemia. Furthermore, extravasation of evans blue dye (EB, 100mg/kg) were observed 30 minutes after ischemia. SMA-SOD increased CBF during the hyperemia, and improved both delayed post-ischemic hypoperfusion (DHP) and neurologic outcomes. Extravasation of EB were recognized in the control group, but not in the SMA-SOD group.
In conclusion, vasogenic edema might play a role in the elevation of ICP besides the hyperemia, and SMA-SOD improved neurologic outcome by prevention of edema, and improvement of DHP. Furthermore, free radicals might play a role in the appearance of ischemic brain damage.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991Biotin 標識 probe を用いた histo in situ hydridization 法による胃癌組織における癌遺伝子 mRNA の検討247255ENIzuruTanakaExpression of oncogene mRNA in gastric cancer was studied by in situ hybridization. Cancer tissues were fixed in formalin and embeded in paraffin. Then, DNA-mRNA hybridization was performed by using two biotin-labeled cDNA probes (c-myc, c-Ha ras).
Oncogene mRNA was intracuelularly localized, mainly in the cytoplasm, and also found in the nucleus of partial cells. Higher concentrations of oncogene mRNA vere found in advanced cancers than in early cancers, and in metastatic positive cases of the above n2 than of n0 or n1.
This suggests that the expression of oncogene mRNA is related to the malignant potency of cancer.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991ファンコニー貧血に自然発生する特異的染色体切断点の悪性腫瘍発生における意義235246ENKazushiroTsujiIndividuals with Fanconi anemia (FA) are susceptible to acute non-lymphocytic leukemia (ANLL) or hepetocellular carcinoma. To clarify why FA is associated with a specific type of neoplasia, we performed cytogenetic studies on somatic cells established from 4 FA patients, two of whom developed acute myelocytic leukemia (AML). A hypersensitive response to mitomycin C (MMC) was obtained in two patients but non-sensitivity in two patients with AML. Analysis of spontaneous break-points showed that the frequency of breakage in the FA patients was 4 to 5 times higher than in normal controls. Significantly more breakpoints gathered on 1p11 or q11, 1q21, 1q32, 2p11, or q11, 3p14, 3q21, 5q15, 7p11 or q11, 8q22, 9q11-12, 9q13, 11q13, 11q23, 12q13, 12q24 and 17q21 bands. Furthermore, many chromosome rearrangements involving these breakpoints were observed. Most of the breakpoints specific to FA coincided with those seen in the rearrangements of ANLL reported so far. These findings suggest that the nonrandomness of spontaneous breakpoints plays an important role in the tumorigenesis of FA.No potential conflict of interest relevant to this article was reported.