岡山医学会Acta Medica Okayama0030-15581021-21990第2回 岡山骨移植研究会277279ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990第10回 中国脳卒中研究会269276ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990電子線治療時におけるエネルギー低減方法に関する検討217225ENYoshitadaNakagiriToshiharuYamadaKatsuhikoSugitaYasutakaMikamiYoshihiroOhkawaKenjiInamuraNobuhiroOguriIsaoNagayaToshiakiNoriyasuYoshioOkazakiNobuhiroInoueIzumiTogamiYoshioHirakiThe declerator and bolus, which reduce radiant energy in electron beam radiotherapy, were investigated with respect to the interrelation between their quality of material, thickness and position, and the mean energy anf depth-dose rate curve pattern. The data obtained indicated that an acryl decelerator fitted to the tube aperture had the disadvantage of entailing bremsstrahlung x-ray intervention as well as increased depth dose. An elastomeric bolus placed on the phantom surface, however, resulted in an increase surface dose and minmal x-ray intervention. When radiation was performed with the phantom surface held apart from the bolus, a build-up phenomenon occurred on the phantom surface with a consequent diminution of surface dose. It was concluded that a bolus is more effective than a decelerator fitted to the tube aperture for attenuation of radiant energy. It is more advantageus to irradite with the bolus in contact with the skin in cases in which the target is localized in the superficial layer of the skin, and with the bolus apart from the skin in cases in which the target is situated deeper below the skin.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990アデノウイルス誘発マウス腫瘍における myc 群癌遺伝子の増幅と発現209216ENTakeshiOkinoAmplification and expression of myc-related oncogenes were studied on adenovirus-induced tumors (D and IC) and spontaneous hapatoma (P), all of which had been successively trans-planted in C3Hf/OK mice. c-myc expression waas elevated in the D, IC anf P tumors, and a 8.9-fold amplification of c-myc was observed in the IC tumor. In the D tumor N-myc expression was elevated and a 1.9-fold amplification of N-myc was also observed. Amplification of c-myc in the IC tumor was suspected to be a result of selection for c-myc amplified cells during successive transplantation. Although expression of genes, c-myc, N-myc and E1A of adenovir-us, suppress each other, the results of this experiment, especially elevated expression of N-myc and c-myc in the D tumor, implicated deregulation of myc family genes in malignancies indiced by adenovirus.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990内在性小胞体内 A 粒子の構成蛋白に関する研究ーアデノウイルス12型誘発マウス腫瘍に認められた粒子についてー199207ENEiichiroHirakawaAnalysis and purfication of structural proteins of intracisternal A particles produced in adenovirus-induced tumor were described. SDS-PAGE of purified intracisternal A particles demonstrated its major structural components, K92, K70 and K55, and minor components, K43 and K37. Two dimensional gel electrophoresis indicated a pI of K70 and K55 at 6.5 and 6.3, respectively, in the presence of sodium dodecyl sulfate. Purification of the main band, K70, in SDS-PAGE using reversed phase-HPLC was difficult in the standard acidic condition, but could be achieved in the neuttral condition. Although purificatin of K70 is generally difficult because of its hydrophobicity, the method shown here will be useful for furthey study of structural proteins of intracisternal A particles.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990心房細動合併脳梗塞症例の臨床的検討189197ENSogoTaijiMasashiKumuraNaokiKobikiNozomiOgasawaraShoichiHaraokaDaijiSaitoTakaoTsujiA retrospective study of 166 cases of cerebral infarction who were treated at the Takamatsu Red Cross Hospital from 1983 to 1986 was conducted. 1) There was no significant relationship between cases of cerebral infarction deaths and smoking, alcohol consumption, high blood cholesterol levels, high blood neutral fal levels or diabetes. 2) Those cases of cerebral infarction which were complicated by heat disease or atrial fibrillation demonstrated a significantly higher mortality rate. 3) From among a total of 20 cases of cerebral infarction complicated with heart disease, 12 cases had a simultaneous complication of atrial fibrillation. The most common type of heart disease observed was cardiac valve disease, which was present im 7 of the cases. 4) All 4 cases of cardiac infarction were not complicated by atrial fibrillation. 5) All of the cases of death due to cerebral infarction compicated by heart disease were also complicated by atrial fibrillation. These finding indicate the importance of atrial fibrillation in cases of cerebral inflarction. A study of the clinical picture of cases of cerebral infarction complicated with atrial fibmillation was conducted. 1) The clinical picture od cases of cerebral infarction complicated by atrial fibrillation frequently involed cerebral embolism and the site of infarction was frequently observed to be the dendrifrom cerebral cortex. In addition, these cases were usually quite severe, even resulting in consiousness disorders and also involved a high mortality rate. 2) In comparison to cases which were not complicated by atrial fibrillation, there was no significant difference observed between such cases nd survivors of cerebral infarction complicated by atrial fibrillaiton in terms of their function of movement and social life style. Based on the above, atrial fibrillation is believed to be a major risk factor of cerebral infarction irrespective of the presence or absence of underlying disorders.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990左室肥大例における運動負荷QRST isointegral mapと運動負荷(201)Tℓ心筋シンチグラムの対比検討177188ENHidenoriHagiharaFor evaluating execise-induced myocardial ischemia in patients with ECG finding of left ventricular hypertrophy (LVH) with ST-T change, we recorded the body surface maps (QRST area maps) from 87 lead points before and after exercise and studied the patterns of the subtraction QRST area maps (S-maps) subtracting preexercise from postexercise maps in comparison with the findings of stress thallium (Tl) scans in 35 patients with hyertrophic cardiomyopathy (HCM) and 9 patients with essential hypertension (EH). All 21 patients whose S-maps revealed small changes less than -40μ VS or an increase only on the anterior chest region shoued no signigicant findings in the stress Tl scan. There were clear positive findings on the stress T1 scan in 7 of 8 patients with HCM (88%) whose S-maps revealed negative changes greater than -40μ VS on the wide precordial region and in 6 of 8 patients with HCM (75%) whose S-maps revealed increases on the anterior chest region but also had accompanying negative changes greater than -40μ VS somewhere on the precordial region. These results suggest that exercise QRST area maps may be useful in the identification of exercise-induced myocardial ischemia, especially in patients with HCM whose ECG showed LVH with ST-T changes. However, there were no significant findings on the stress T1 scan in 6 of 7 patients with EH whose S-maps revealed negative changes greater than -40μ VS on the precordial surfacre the same as those of HCM. These results suggest that factors other than exercise-induced myocardial ischemia such as the antonervous system may influence the ST-T cahanges in the EH cases. The specific mechanisms responsible for ischemic changes in patients with LVH (especialy in those with HCM) are not clear, although small vessel disease combined with myocardial hypertrophy or myocardial squeezing may be causative factors.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990MR 画像データベースシステムの開発とその臨床応用に関する研究165176ENToshiakiNoriyasuA magnetic resonance (MR) image detabase system has been developed. The purpose of this paper is to present this system and its application. It consists of an image processing system and database system to handle data of clinical cases and a medical knowledge base. Using the image processing system and the database system with stored data of clinical cases, the MR image data of cases can be retrieved by diagnosis as well as ID number, patient's name, etc., and MR images can be processed. By using the database system with the medical knowledge base, differential diagnoses can be offered.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990ハロペリドール長期投与後のラット線条体 D-1・D-2 受容体の変化―間欠投与・持続投与・超長期時持続投与の比較―153164ENHiroshiNishikawaThe effects of long-term treatment with haloperidol (2mg/kg/day) on dopamine receptors in the rat striatum was examined using in vitro quantitative autoradiography. Rats treated with haloperidol showed an increase in striatal D-2 receptor binding as revealed by [(3)H] spiperone. Striatal D-1 receptos labeled with [(3)H] SCH 23390 were not changed following treatment with haloperidol in young rats for 2 weeks, while, it was decreased following 85 weeks of tretment. The striatal D-1 receptors were decreased also after a 4 week treatment with haloperidot in aged rats. These results suggest that haloperidol treatment in the aged rats results in D-2 receptor supersensitivity and a decline in D-1 receptors. Such relative supersensitivity of the D-2 receptor over the D-1 receptor may be related to the vulnerability to tardive dyskinesia of the aged.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990ヒトアデノウィルス12型誘発腫瘍におけるE1領域遺伝子の組み込みと発現143152ENTomokoMorikawaIntegration and expression of human adenovirus type 12 (Ad12) were studied on two Ad12-induced tumor lines of C3Hf/OK mouse origin (IC and D tumors). Southern hybridization using whole Ad12 genome as probe demonstrated that DNA of IC and D tumors contained about 9 and 23 copies, respectively, of the entire Ad12 genome eqivalent per diploid cell. Left ends of Ad12 DNA appeared as off-size bands, indicating their linkage to different cellular DNAs. Southern hybridization using and Ad12 EcoRI-C fragment containing the E1 region as a probe revealed that intergration sites were much fewer than presumen numbers of integrated Ad12 genones. These results suggested that the viral and cellular DNA complex was repeated at integration sites. Northen hybridization using an Ad12 EcoRI-C fragment as a probe showed that tha E1 region was transcribed in both IC and D tumors. Much more intensive expression in the D tumor suggested possible dependence of the expression of the E1 region on the copy numbers of Ad12 genomes.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990一過性虚血後の慢性期ラット脳における生化学的変化に検する研究129141ENHiroshiYoshikawaIn recent years, cases of sequelae of cerebrovascular disease such as vascular dementia due to death of many neurons have been increasing. Such neuronal death following brain ischemia had been considerd to be due to an energy deficiency resulting from an impaired respiratory chain. However, the detection of the delayed neuronal death showed that neuronal death is not caused by mere energy deficiency. Most previous studies on delayed neuronal death focused on the changes in morphology and energy metabolism in the acute to subacutte stage. There are few reports concerning biochemical changes in the chronic stage, especially in neurotransmitter receptors. Transient ischemia for 20 minutes in a rat four-vessel occlusion model was induced, and serial histological and biochemical changes were evaluated until the chronic stage. Destruction of pyramidal cells in the CAI area of the hippocampus was completed by 10 days after cerebral ischemia followed by recirculation of cerebral blood flow. Light microscopy showed no progression after this day. The level of acetylcholine (ACh) was significantly decreased in the hippocampus, striatum, and frontal cortex at the termination of ischemia but recovered to normal 21 days after recirculation of cerebral blood flow. The binding sites of muscarinic ACh receptors (mACh-R) per usit of protein were increased in the hippocampus 21 days after recirculation of blood flow. However, no changes were observed in the total number of mACh-R in the entire hippocampus. Thuse finings suggest no changes in the ACh neuronal system in the chronic stage and no direct association between this ayatem and delayed neuronal death. On the other hand, N-methyl-D-aspartate (NMDA) receptors, a subtype of glutamate receptirs, showed no change in the hippocampus until after 10 days, but decreased to half after 21 days despite no evidence of histological progression of neuronal death. Thus, delayed neuronal death after transient forebrain ischemia appears to be deu to release of glutamate, an excitatory amino acid. Our findingd show the specific death of neurons with NMDA receptors for glutamate.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990マウスに経口投与した放射性標識トルエンの生体内運命113127ENKuniyasuFujisawaMice ingested (14)C-toluene orally, and the redioactivities of toluene and its metabolites in the blood, organs, urine, feces and exhaled air were determinated using liqid scintillation counter. Toluene absorbed from the digestive tract after 8 hours was caluculated by the ratio of subtracted amounts in digestive organs and feces from ingested toluene to ingested toluene was 98.92% and the ratio of amounts in mice excepting digestive organs, expired air and urine to ingested toluene was 92.09%. The ratio of toluene in expired air to ingested toluene after 8 hours was 31.15%, and of toluene as urinary metabolites was 16.64%. The concentration of toluene in the blood attained its maximum 60 minutes after ingestion and decreased with a half-life of 95 minutes. Concentration of toluene metabolites in the blood attained its maximun 120 minutes after ingestion and decreased with a half-life of 155 minutes. Amount of toluene in the exhaled air attained its maximum 60-75 minutes after ingestion and decreased with a 48 minute half-life. The concentration of toluene in blood and organs 180 minutes after ingestion was, in decreasing order, adipose tissue, kidneys, liver, cerebrum, and blood and concentration of toluene metabolites was, in decreasing order, kidneys, liver, blood, cerebrum and adipose tissue. Metabolites in blood and kidneys were identified as benzoic acid and hippuric acid, respectively. The metabolites in the liver was solely benzoic acid.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990有機溶剤の生物学的モニタリングのための尿試料の保存と尿中濃度の補正について99111ENToyohiroTaguchiAn attempt was made to establish a method for the direct determination of urinary concentration of creatinine, hippuric acid (HA), methylhippuric acids (MHA) and mandelic acid (MA) by high performance liquid chromatography (HPLC). For assays of stored urine samples, urine was spotted on filter paper or filter paper was dipped in urine. The filter paper was dried and kept several weeks, and then MA, HA, o-MHA, (m+P)-MHA and creatinine in the filter paper were eluted with 50 vol% methanol, and their concentration were determined by the HPLC method. The correlation coefficient found between the concentration of organic solvents (toluene and xylene) in the air and of the metabolites (HA and MHA) in worker's urine, corrected for creatinine and /or specific gravity, was higher than that between the organic solvent concentrations and the uncorrected metabolite concentrations. The ratio of HA concentration to creatinine concentration in the urine of students unexposed to toluene after physical exercise was similar to that before exercise. Individual spot samples of urine of unexposed subjects were measured for HA over 24-hours at appropriate intervals. When HA in these specimens was calculated with correction for creatinine and/or specific gravity, the variation coefficient was reduced. In cases of spot samples of workers' urine, correction for creatinine and/or specific gravity is practically useful in both individual and group urine analysis. Especially in over concen-trated urine samples, satisfactory results can be obtained by correcting fer creatinine rather than correcting for specific gravity.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990肝細胞 spheroid に観察される vermipodia 様細胞突起8797ENTakayoshiTanabeThe presence and function of vermipodia-like processes of hepatocytes-multicellular spheroids formed in primary culture was described. Cine microscopy and scanning electron microscopy revealed that about 1-5% hepatocytes in single cell after culture initiation already posessed the processes. The processes disappeared when the hepatocytes attached and spread, and than appeared again on the surface of multicellular spheroides. The processes were moving by extending, shrinking and twisting, and sometimes extended 50 um. Five to ten percent of spheroids had 1-5 processes. Occasional collision of two spheroids resulted in the fusion of spheroids after their processes intertwined, attached to the partner spheroid and shrunk. Electron microscopy revealed that the processes were larger in size than the numerous microvilli co-present on the free surface of spheroids and their cytoplasm had scarece orgalella. The morphological characterisitcs of the processes most resembled those of vermipodia reported in histiocytic leukemia cells.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990Pringle 法急性肝流入血行遮断の肺血管外水分量におよぼす影響 第2編 上腸間膜動脈遮断と門脈一体循環シャント造設の効果を中心として7786ENNobujiYokoyamaTo elucidate the effect of portal congestion on pulmonary interstitial edema after temporary hepatic ischemia by Pringle's maneuver, extravascular lung water (EVLW) was experimentally measured using a modified double indicator dilution method before and after interruption of the hepatic blood flow follwing clamping of the superior meaenteric artery or portofemoral vein bypass. The following results were obtained. 1) Compred with clamping of the superior mesenteric artery, the portofemoral vein bypass reduced the increase of EVLW after temporay hepatic ischemia by Pringle's maneuver. 2) The increase in EVLW had a tendency to be influenced by the degree of metabolic acidosis and portal congestion. These findngs suggest that the portofemoral vein bypass is more effective in the prolongation of the safe period of temporary hepatic ischemia by Pringle's maneuver than clamping of the superior mesenteric artery.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990Pringle 法急性肝流入血行遮断の肺血管外水分量におよぼす影響 第1編 肺血管外水分量の増加とその成因を中心として6376ENNobujiYokoyamaTo elucidate the effect of total hepatic ischemia on pulmonary organs, extravascular lung water (EVLW) was experimentally measured using a modified double indicator dilution method before and after interruption of the hepatic blood flow using Pringle's maneuver. The follow-ing results were obtained : 1) EVLW was significantlly increased more than one hour after temporary total hepatic ischemia. 2) Temporary hypotension resulted in little increase of EVLW by removing and replacing some blood volume through the femoral artery. 3) Pumonary interstitial edema was histologically and maroscopically observed in the Pringle's maneuver group. 4) Marked metabolic acidosis and elevation of serum transaminase were revealed after temporary hepatic ischemia. These findings auggest that pulmonary interstitial edema may result from sfter temporary total hepatic ischemia by Pringle's maneuver and the changes of EVLW are caused by increased permeability due to liver injury, metabolic acidosis and portal congestion.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990ヘッドホン使用と聴器障害―中・高校生における耳科疫学的検討―5161ENKatsuroFurukawaA survey was performed at 3 junior and 2 senior high schools in Kagawa Prefecture, in order to carify the use of headphones and the possibility of auditory damage due to headphones. Out of 2,217 students, 46.1% used “headphones”, including earphones and so-called Walkman-type headphones. Most of them used the headphones to listen to music. There was a significant difference in the incidence of cochlear symptoms between headphones users and non-users. In junior high school students, the incidence of cochlear symptoms was higher in those who had used headphones for more than four years and in those who used headphones for more than two hours per day. The extent of use correlated with the incidence of cochlear symptoms and the results indicate the possibility that acoustic injury could be caused by headphones.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990核 DNA 量による乳癌の悪性度判定ならびに内分泌療法の作用機序の研究―Flow cytometry による解析―3749ENHiroyoshiDoiharaTo evaluate for primary breast cancer, flow cytometric DNA analysis has been performed on 105 paraffin-embedded tissues. The S-phase fraction and proliferation index correlated significantly with clincopathological factors, sunh as n-number, tumor size, histological stage and hormone receptors. However, there was no correlation between the level of ploidy and the clinicopathological factors. DNA analysis using flow cytometry was found to be useful for the estimation of prognosis and evaluation of malignancy of breast cancer. The effect of medroxyprogesterone acetate (MPA) on primary breast cancer cell kinetics was investigated by flow cytometry. Nuclear DNA contents were measured in 67 cases. MPA, 1,200mg/day, was orally administered for two weeks in 12 cases (MPA group) and the remain-ing cases (n-MPA group) served as the controls, until the day before operatopn. The DNA histograms were compared between both groups. The mean percentage of G0 + G1 phase was higher and that of S-phase and G2 + M phase, lower, in the MPA group than in the n-MPA group. Especially in estorogen receptor-positive and premenopausal cases, significant differ-ences were present between both groups. These results suggest that MPA could inhibit DNA synthesis with a delay of the cell cycle progression in human breast cancer.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990損傷の法医学的考察―司法解剖13例について―2336ENRyoNanikawaYoshiakiHashimotoFumioMoriyaSatoruMiyaishiMiyokoNakaiXuYangChun GangGuoIn this paper we present 13 autopsy cases on interest in medico-legal traumatology. The cases are as follows : 1)two cases of incomplete cardiac rupture dur to thoracic trauma, 2)rupture of herniated large intestine due to abdominal trauma, 3)large incised wounds on the side of the neck by a small kitchen knife, 4)a homicidal case with similar wounds that accompanied self-inflicted wounds, 5)a homicidal case accompanied by multiple stab wounds on the chest, 6)an accidental death skewered by a slender metallic stick, 7)special fatal shotgun injuries, 8)a homicidal case accompanid by various burns by an electric hair-dryer, iron and ciga-rettes, 9)two murder cases by a metallic baseball bat, 10)a suicidal case due to a fall from a high place, and 11)a severely disrupted victim of a road traffic accident.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990小児における下部食道内pH動態の研究―24時間食道内pH monitoring による解析―722ENYasuhiroWatanabeTwenty-four-hour esohageal pH monitoring in infants and children has been performed to clarify pH dynamics of the lower esophagus using a pH histogram and acid clearance value in addition to pH score. A pH histogram showing the total state of pH dynamics in the lower esophagus ia constructed with whole pH data obtained by 24-hour pH monitoring. An acid clearance value indication the clearance ability of the esophagus is calculated by pH curves. 1) The normal acid clearance value is under 100. 2) Lower-side-tail of the pH histograms has been analyzed with an acid clearance value and other parameters of gastric acid reflux into the esophagus. Several characteristic pH dynamics are observed in cases of apparently normal patterns and mild gastroesophageal reflux (GER) which were diagnosed by a conventional manner : (a) moderate reflux with good clearance ability, (b) prolonged running status between pH 3 and 4, and (c) mild and pathological reflux with impaired clearance cbility. 3) pH histograms of the GER type are divided into 2 subtypes : The flattened subtype, which indicates ture GER with incompetence of the lower esophageal sphincter (LES), and the peaked subtype, which is often observed in cases of hypertrophic pyloric stenosis and has a well-functioning LES without pathologic GER.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990腸閉塞を初発症状とする非特異性多発性小腸潰瘍の一例―本邦報告95例の検討―16ENHiromiIwagakiShoYunokiYasuhikoHiguchiSadanoriFuchimotoKunzoOritaYasushiHorieNon-specific multiple ulcers of the small intestine is one of the new disease entities, differing from Crohn's disease and simple ulcers of the small intestine. The clinical course of this disease ia still poorly understood, and the factors which inflence the progression or healing of these lesions remain unknown. We reviewed 95 cases of non-specific multiple ulcers of the small intestine in the Japanese literature. Non-specific multiple ulcers were seen primarily in young adults, although our patient was a 73 year-old female. The main symptoms of this disease included occult blood in the stool, anemia, hypoproteinemia, abdominal pain and ileus. Our case was accompanied by ileus at the onset without anemia and hypoproteinemia. Almost all of the patients have a clinical course of long duration. Macroscopic examinations in this disease are characterized by multipe shallow ulcers (UL-I-II) developing crosswise or obliquely on the intestinal mucosa and several areas of stenosis. No cases of perforation, fisula fornation, obstruction or abscess were noted. The recurrence rate was 26.3%.No potential conflict of interest relevant to this article was reported.