岡山医学会Acta Medica Okayama0030-1558977-81985腸球菌および糞便性大腸菌群の海域における汚染指標性の比較検討777781ENIzumiKoujimaYoshikazuHiraiJunjiShiodeKaoruTerasakaAkinobuOkabeYasuhiroKanemasaA sampling of seawater was carried out on the coast east of Okayama Prefecture in 1984. Thirty samples of seawater were collected at 10 sampling points near beaches and were examined for both enterococci and fecal coli form group bacteria. The MPN technique was used for the detection of enterococci, and the MF technique for fecal coli form group bacteria. Enterococci were detected about 7.7 times as often as fecal coli form group bacteria. The correlation coefficient was high(r=0.8) when the bacterial numbers of both groups were plotted as logarithms. This result indicates that both bacteria can serve as a reliable indicator of the fecal pollution of seawater. However, the detection of enterococci using the MPN technique is more suitable for routine testing than that of the fecal coliform group with the MF technique in terms of the test performance and the cost involved.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985モノクローナル抗体を用いた肺癌組織浸潤リンパ球の研究761775ENTetsuyaWatanabeSubsets of the infiltrating lymphocytes in lung cancer tissues of 64 patients were identified by immunohistochemical staining (ABC method) using monoclonal antibodies (Leu 2a, Leu 3a+b, Leu 4, Leu 7 and Leu 14). T cells were predominant in lung cencer tissues, and tended to infiltrate into cancer cell nests and stoma, diffusely and focally. On the contrary, B cells in most cases were observed to infiltrate focally apart from cancer cells. There was a significant reverse correlation between the intensity of the T cell infiltration and the tumor T factors, and also between Th/i cell infiltration and the tumor T factors. Th/i cells were more prominent in lung cancer than Ts/c cells, and Ts/c cells scarcely infiltrated. NK, K cells also infiltrated scarcely and sparsely, and there was no correlation between the intensity of NK, K infiltration and the clinical condition. It was concluded that immunohistochemical examination of infiltrating lymphocyte subsets in lung cancer can reveal direct local immune responses and may be a useful method for making prognoses.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985Staphylococcus epidermidis色素産生株の色素の性状について749759ENKazuteruOgoThe major pigment isolated from S.epidermidis cells grown at 37℃ was analyzed by various physicochemical methods. The chemical structure was presumed to be glucopyranosyl-1-0-(4,4'-diapo-7',8',11',12'-tetrahydrolycopen-4-oate)-6-0-(2-methyl butanoate). The effect of growth temperature on the production of pigments was studied by HPLC. Cells grown at 25℃ had a different C(30)-carotenoid as the major pigment from cells grown at 37℃. Cells grown at 42℃ had a pigment which was not a carotenoid. By shifting the culture temperature from 37℃ to 25℃ or 42℃, the composition of the pigments did not change, but the amount of pigments increased in the case of a shift to 25℃.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985心筋細胞の特殊顆粒に関する比較解剖学的・電子顕微鏡的研究713748ENKeikiYoshitakeSpecific granules of heart atrial and ventricular muscle cells obtained from vertebrates, especially Pisces, were investigated by electron microscopy. The heart muscle cells of Pisces were generally smaller than those of other vertebrates, and the ratio of nucleus to cell body was large. The cells could be classified into three types according to the degree of development of cell organella: cells with long myofibrils, many Golgi apparatus and many mitochondria; cells with short myofibrils, a few Golgi apparatus and a few mitochondria, and cells with few myofibrils and a few mitochondria. In Pisces, specific granules were only found in a small population of heart muscle cells and most cells had no granules in contrast to mammals. The distribution of granules was diffuce, and granules did not gather. The mean diameter of these granules was as follows: 124nm (lamprey), 200nm (ray), 110nm (sillago), 130nm (Sebastes), 160nm (flathead), 130nm (goby), 97nm (flounder), 110nm (turbot), 160nm (sea bream), 124nm (gray mullet), 180nm (eel), 110nm (loach), 110nm (ayu), 120nm (carp), 120nm (crucian), 110nm (gold fish), 120nm (Rana), 133nm (Geoclemmys), 146nm (snake), 144nm (chicken), 260nm (rat), 170nm (dog) and 210nm (pig). The number of specific granules distributed in heart atrial muscle cells was large in the rat, medium in Geoclemmys, the snake, Rana and lamprey, and small in the chicken, dog and pig. The number in Pisces was large in gray mullet, medium in flathead, goby, flounder, turbot, sea bream, loach, ayu, carp, crucian, gold fith and eel, and small in ray, sillago and Sebastes. The number of specific granules distributed in heart ventricular muscle cells was large in Geoclemmys, the snake and Rana, medium in lamprey, the chicken and dog, and small in the rat and pig. In Pisces, the number was large in gray mullet and flathead, medium in goby and flounder, and small in ray, sillago, Sebastes, turbot, sea bream, eel, loach, ayu, carp, crucian and gold fish. Specific granules were present in heart atrial muscle cells and heart ventricular muscle cells in all vertebrates studied.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985ヒト肺癌実験モデルの作製に関する研究 第2編 ヒト肺扁平上皮癌細胞株(EBC-1株)およびヒト肺腺癌細胞株(ABC-1株)の異種移植701712ENYoichiWatanabeTwo continuous cell lines, which were designated as EBC-1 and ABC-1, were recently established from explant cultures of human squamous cell carcinoma and adenocarcinoma of the lung in our laboratory. In the present study, for the purpose of making an animal model of human lung cancer, cells of EBC-1 and ABC-1 were transplanted into antilymphocyte serum (ALS)-treated newborn hamsters and into nude mice. The EBC-1 line was serially transplanted for 10 passages into ALS-treated newborn hamsters. When 0.75-24.0×10(5) cells were inoculated intraperitoneally or subcutaneously, 36 of 38 experimental animals developed invasive tumors 19-35 days after implantation. Metastases to the lungs were observed in 28 of 36 hamsters with tumors. The EBC-1 line was also transplantable to nude mice, but the tumor growth was very slow and serial transplantation was not successful. The ABC-1 line was transplantable to ALS-treated newborn hamsters, but propagated for only two passages. When 4.0-14.0×10(5) cells were inoculated intraperitoneally or subcutaneously, 14 of 20 experimental animals developed invasive tumors 28-33 days after implantation. The ABC-1 line was transplantable, but not serially transplantable to nude mice. In conclusion, EBC-1 when implanted into hamsters was a good model of human lung cancer. To my knowledge, this is the first report of a high frequency of lung metastases in the heterotransplantation of human lung cancer. This animal model should be useful for various studies of human lung cancer including mechanism of metastasis and chemosensitivity of anticancer agents.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985ヒト肺癌実験モデルの作製に関する研究 第1編 ヒト肺扁平上皮癌細胞株(EBC-1株)およびヒト肺腺癌細胞株(ABC-1株)の樹立とその性状691700ENYoichiWatanabeTwo human lung cancer cell lines designated as EBC-1 and ABC-1 were newly established for the purpose of making an in vitro experimental model of human lung cancer. The EBC-1 line was established from a metastatic skin tumor of a patient with squamous cell carcinoma of the lung. The cells grew in a monolayered sheet with a population-doubling time of 42 hr. The chromosome number showed wide variation from 35 to 102 with a modal peak at 53. The ABC-1 line was established from pleural effusion of a patient with adenocarcinoma of the lung. The cells grew mainly in a floating clump with a population-doubling time of 72 hr. Karyotypic analysis disclosed a wide variation from 25 to 57 with two modal peaks at 53 and 54. The EBC-1 and ABC-1 lines may be useful for biological, cytopharmacological and therapeutic studies of human squamous cell carcinoma and adenocarcinoma of the lung.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985骨膜下顎骨離断術後の骨新生に伴う血管像の変化に関する実験的研究677689ENHisaoNagayamaWhen jaw resection is necessitated by mandibular tumors, deformities and dys- or hypofunction of the jaw are unavoidable. To secure recovery from impairment, prostheses of the jaw bone, for instance, artificial substances or autologous bone, are usually utilized. When an artificial substance is used, however, it is difficult to obtain satisfactory results due to poor tissue affinity and compatibility. When an autologous transplantation is performed, healthy tissue other than the lesion it self is inevitably damaged in addtion to bone fragments being required from the patients. Recent reports have shown that bone regeneration occurs without bone transplantation if the periosteum is left behind at the time of jaw resection. Thus, attention has been paid to bone regeneration by the periosteum, especially among young patients. To my knowledge, there have been no reports concerning vascular and bone regeneration after subperiosteal hemimandibulectomy. Subperiosteal hemimandibulectomy, including removal of the mandibular head, was performed in rabbits. Dry-cast models were prepared by resin injection into the carotid artery, and transparent specimens were prepared by chloropercha injection into the carotid artery. Regeneration of blood vessels and bone were observed macro- and microscopically. During the initial stage, blood supply to the site of the bone defect was made mainly from periosteal blood vessels. The periosteal blood vessels, related to bone regeneration, gradually developed and anastomosed with the blood vessels extending from the bonr marrow, resulting in a fine vascular network. The external carotid, facial, and transverse facial arteries extended to the site of the bone defect approximately thirty days after the operation. The periosteal, bone marrow and extramaxillary blood vessels probably play an important role in bone regeneration.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985悪性リンパ腫の化学療法に関する研究 第2編 進展期悪性リンパ腫に対する多剤併用療法の治療効果:長期観察による検討661676ENRyujiNishiharaResults of combination chemotherapy for malignant lymphoma between 1973 and 1982 were analysed. In this series there were 17 patients with Hodgkin's disease (HD) and 109 patients with non-Hodgkin's lymphoma (NHL). None of the patients had prior chemotherapy. The two basic treatment programs in this series were BVCP or BCOP (combination of bleomycin, vincristine, cyclophosphafamide and prednisolone) and AVIP(combination of adriamycin, vincristine, ifosfamide and prednisolone). Of the 17 HD patients, 14 (82%) were effectively treated and achieved complete remission(CR). Six of the 14 patients relapsed between 15 and 65 months, while the remaining 8 patients have been disease-free between 8 and 126 months. The projected median CR duration was 65 months. No recurrent disease has occurred among 5 patients who were given AVIP as intensification therapy, suggesting the usefulness of adriamycin in the treatment of HD. Complete responders survived significantly longer than partial responders: 83% of the former survived 5 years, but none of the latter survived that long. Of the 109 patients with NHL, 25 patients had diffuse medium cell type histology(DM) and 43 patients had diffuse large cell type histology(DL). For DM, the CR rate was 64%, and the median response duration was 10 months. Of the 16 CRs, 9 have relapsed so far; however, the remaining 7 have been disease free for 12 to 95 months. For DL, the CR rate was 63% and the median remission duration was 43 months. Of the 27 CRs, 13 have relapsed so far, but the remaining 14 have been disease free for 13 to 115 months. The median survival time was 75 months for DM, and 23 months for DL. Complete responders lived significantly longer than partial or none-responders in DL. Prognostic factors were analysed in DM and DL patients. Among the chemotherapy effect, stage, constitutional symptoms, serum LDH, C-reactive protein (CRP), lymphocyte count of peripheral blood, and erythrocyte sedimentation rate(ESR), a CRP over 3+ and ESR over 30mm/hr were defined as poor prognostic factors for DM. Remission induction failure and CRP over 3+ were defined as poor prognostic factors for DL. Sixteen (6 HD and 10 NHL) of 72 complete responders (14 HD and 58 NHL) were disease free for at least 2 years after cessation of all treatment, suggesting that HD as well as NHL is curable by intensive combination chemotherapy.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985悪性リンパ腫の化学療法に関する研究 第1編 マウス自然発生リンパ肉腫(LS-1)をモデルとした悪性リンパ腫の化学療法に関する検討649660ENRyujiNishiharaA murine lymphosarcoma (LS-1) which originated spontaneously in a DBA/2 mouse, was evaluated as a model of malignant lymphoma for drug screening and combination chemotherapy. Antitumor activity was distinct in the order of L-asparaginase (LASP), mitoxantrone, a new anthraquinone analogue (MIT), ifosfamide (IFO), cyclophosphamide (CPA), adriamycin (ADM), and aclarubicin, a new ADM analogue (ACR), when measured as increased life span of mice intravenously implanted with LS-1 and intraperitoneously treated with antitumor agents at an optimal dose. Methotrexate (MTX), vincristine (VCR), and vindesine (VDS) were marginally active against LS-1. Nitrosourea compounds, such as BCNU and ACNU, and bleomycin were inactive against the tumor. The murine lymphosarcoma, LS-1, appeared to provide a drug activity spectrum closely analogous to malignant lymphoma in man except for LASP. The combination of IFO and MIT was the most effective among six 2-drug combinations. CPA and MIT, IFO and ADM, and CPA and ADM were also effective combination. ACR, however, appeared antagonistic to IFO and CPA, since in combination with these agents, ACR did not prolong the life-span at any dose, as compared to the optimal dose of IFO or CPA alone. The murine experimental system using LS-1 should be usefull as a chemotherapy model of malignant lymphoma in man.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985総胆管結紮とその閉塞解除後の肝の微細構造の変化に関する実験的研究623647ENSeiheiTamuraRecently, a radical operation on jaundiced patients is performed after biliary decompression by PTCD. In this study, the mechanism of liver cell recovery after biliary decompression was studied hisologically and electron microscopically. Thirty adult dogs were used. After laporatomy, the common bile duct was doubly ligated and severed. The obstruction was released by cholecystoduodenostomy, 2 (Group 1), 3 (Group 2), 4 (Group 3) and 5 and 6 weeks (Group 4) after the operation. A liver biopsy was obtained at the second operation. Four weeks after the second operation, all dogs were sacrified. Liver specimens were taken and examined histologically and electron microscopically. Two weeks after ligation, a marked decrease in glycogen particles, moderate dilatation of bile canaliculi, swelling of Kupffer cells, edema and infiltration of inflammatory cells in the interlobular connective tissue, increase in smooth endoplasmic reticulum and enlargement of the Golgi zone were seen in Group 1. Four weeks after release of the obstruction, glycogen particles increased greatly, and smooth endoplasmic reticulum decreased. Generally, the liver cells and bile canaliculi returned to almost thier normal structure. Three weeks after ligation, similar changes occurred in Group 2 as in Group 1, although the changes were more advanced. Four weeks after release of the obstruction, the liver cells returnd to almost thier normal appearance. Four weeks after ligation, the bile canaliculi markedly dilated and microvilli disappeared in Group 3. The increase in smooth endoplasmic reticulum, enlargement of Golgi apparatus, decrease in glycogen particles and appearance of myeloid bodies were prominent. Four weeks after release of the obstruction, these changes were still observed, and the liver cells remained in the recovery process. Five or 6 weeks after ligation, similar changes in Group 4 as seen in Group 3 occurred, but the changes were more advanced. Four weeks after release of the obstruction, the liver cells had not recovered well. The liver cells recovered well 4 weeks after release of up to 3 weeks of obstruction, but ultrastructural changes still remained 4 weeks after release of over 3 weeks of obstruction.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985ブリリアントブルーを用いた色素内視鏡検査による胃粘膜病変の臨床的研究 第2編 胃粘膜表面の色素内視鏡所見に関する基礎的検討607621ENYukioYorimitsuThis report is concerned with basic studies on chromo-endoscopic findings using Brilliant Blue (BB), with special reference to the affinity of BB dye with mucus and fibrin and also to the dissecting microscopic surface structure of the normal and cancerous gastric mucosa. The BB solution stained mucus and fibrin on the mucosal surface of the stomach at pHs ranging from 1 to 4. Stained mucus appeared translucent, and stained fibrin opaque. The mucus or fibrin clot bound with BB appeared blue at any pH of the dyebath, even with a green BB solution at pH 1. A thin layer of mucus was stained with BB and destained with a 1.0% sodium bicarbonate solution in a few seconds at 37℃, while a small piece of fibrin clot was stained and destained much more slowly (in approximately 30 minutes) under the same conditions. The normal mucosa (including fundic mucosa, pyloric mucosa, and that with glandular atrophy and intestinal metaplasia) was covered with a thin layer of viscous mucus. The chromo-endoscopic appearance depended mostly on the stain characteristics of BB and the fine properties of the mucosal surface of the stomach. The "well-demarcated redness" characteristic of a gastric cancer lesion mainly of the depressed type proved to reflect an unstained or less-stained mucosal territory associated with such factors as lack of the normal-appearing layer of viscous mucus over the cancerous surface, easy loss of the insoluble mucus- and fibrin-like substances attached to the cancerous surface, and compactness of the surface structure in the case of well-differentiated tubular adenocarcinomas.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985ブリリアントブルーを用いた色素内視鏡検査による胃粘膜病変の臨床的研究 第1編 胃粘膜病変の色素内視鏡所見に関する臨床的検討587605ENYukioYorimitsuThis report is concerned with clinical studies on a new method of chromo-endoscopy with Brilliant Blue (Food Blue No.1) (abbreviated as BB). In the indirect method, the pretreatment consists of an intramuscular injection of 4mg of Butropium bromide, followed by the patient swallowing a solution of BB and then a second injection of Butropium, after which an endoscopic examination is performed. In the direct method, the pretreatment consists of an intramuscular injection of Butropium followed by the patient swallowing a pretreatment solution without BB. In the latter method, a 0.05% BB solution is sprayed over the gastric mucosa through a cannula during the endoscopic observation. The following conclusions were obtained. Most of the cancerous lesions of the mucosal and submucosal type appeared reddened, whereas most of the bases of benign ulcers and erosions appeared blue. Thus, this method proved to be useful in the differential diagnosis of gastric cancer and benign gastric ulcer or erosion. In addition, its usefulness was enhanced by such features as brightness of viewing, good visualization of the mucosal surface through the dye solution and excellent quality of photographs. The indirect method proved to be superior to the direct method. The optimum concentration of BB dye in the indirect method was 100mg per 120ml for the pretreatment solution. BB dye appeared green in solutions containing more than 70mEq/l of hydrogen ions, both in vitro and in vivo. It appeared green in stomachs with maximal acidity of 98±27mEq/l (n=25), and appeared blue in those with maximal acidity of 33±28mEq/l (n=13) (p<0.005). The above-mentioned amount of BB dye used for this procedure is within the acceptable daily intake determined by WHO in 1969 for BB as food colour.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985岡山県における片側上肢切断者の調査研究573585ENJunichiKusakaOne hundred twelve unilateral upper extremity amputees who were registered at the Okayama Prefectural Rehabilitation Center were studied. There were 5 shoulder disarticulations, 28 upper arm amputations, one elbow disarticulation, 56 forearm amputations and 22 wrist disarticulations. Ninety-four percent of the cases were caused by trauma, such as labor accidents, traffic accidents and war injuries. The phantom limb was recognized in 59 percent. Seventeen percent complained of phantom at all times and showed psychological suppresive tendencies. Although phantom pain was reported in 24 percent, they had no trouble in daily activities. Ninety-five percent had a cosmetic prosthesis, of which 90 percent actually used it, i.e., 52 percent used the prosthesis not only for cosmetic reasons, but also in daily activities, and 38 percent used it for cosmetic reasons only. Fifty percent had a working arm (Arbeitsarm), and 95 percent of them actually used it. Ttey had 1.4 terminal devices on the average, and used the devices according to the kind of labor: such as ploughing, driving a tractor or carpentering. On the other hand, 12 percent had a functional prosthesis, but only 54 percent of them used it. Because there has been a lack of integrated rehabilitation for upper extremity amputees in Japan, functional prostheses have not been used widely. The answers to a questionaire about the upper extremity prosthesis indicated that 21 percent of the amputees should be enlightened as to the usefulness as well as the functional restriction of the upper extremity prosthesis. Moreover, it is necessary to improve the socket and the component.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985河川水汚染指標としての糞便レンサ球菌の菌種分類567572ENIzumiKoujimaKeijiOnoYasumiMoriYasuhiroKanemasaAkinobuOkabeThe authors classified the streptococci isolated from river water. Three hundred ninety strains of cocci were isolated from river water and classified. Of them, 362 strains (93%) proved to be enterococci derived from human and cattle feces. Only 28 strains, 7% of the isolates, were identified as S. faecalis subsp. liquefaciens which can be thought to be derived from insects. The results indicate that the classification of fecal streptococci is a reliable and useful indicator of water pollution.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985急性脳腫脹の発生におよぼす神経性因子および代謝性因子の相互作用に関する実験的研究543565ENYutakaHonmaIt is widely accepted that an increase in the cerebral blood volume (CBV), secondary to loss of cerebrovascular tone, is essential for the development of acute brain swelling (ABS). Studies have shown that disruptions of metabolic and neural control of cerebrovascular tone are responsible for cerebral vasomotor paralysis, and subsequently result in ABS. However, it is not clear whether metabolic or neural control of cerebrovascular tone is predominant in producing ABS. The changes in cerebrovascular tone created by destruction of the cerebral vasomotor center of the brain-stem in animals with decreased cerebrovascular tone due to loss of metabolic control were clarified and the interaction of neural and metabolic control of cerebrovascular tone was observed. Seventy immobilized, artificially ventilated cats were divided into five groups: group I: control; group II: normocapnic hypoxia; group III: normoxic hypercapnia; group IV: increased intracranial pressure (ICP) by brain compression and group V: subarachnoid hemorrhage (SAH). The systemic arterial pressure (BP), ICP (epidural pressure) and CBV (photoelectoric method) were continuously measured. One hour after the parameters stabilized, the dorsomedial hypothalamic nucleus (DM) and the midbrain reticular formation (MB-RF) were bilaterally destroyed by a stereotaxic technique (3mA, 1min).
In group I, brain-stem destruction resulted in a transient decrease in the BP (DM: -14.1±6.7mmHg, MB-RF: -10.2±4.8mmHg) and simultaneous increase in the CBV and ICP (DM: 7.6±7.0mmHg, MB-RF: 6.0±5.6mmHg) for three to four min. In groups II and IV, the ICP (group II, DM: 2.3±2.6mmHg, MB-RF: 1.6±1.2mmHg; group IV, DM: 7.5±4.0mmHg, MB-RF: 4.8±3.2mmHg) decreased after brain-stem destruction presumably due to the preceding vasodilatation caused by disruption of metabolic control. In group III, the BP decreased or increased, and changes in the CBV and ICP after brainstem destruction paralleled those of the BP. Marked hypercapnia probably yielded the maximum cerebral vasodilatation, so vasodilatory effects by brain-stem destruction were completely supressed. In group V, 12 of 15 animals showed essentially the same response patterns of the BP, CBV and ICP as group I after brain-stem destruction. The remaining three animals developed progressive intracranial hypertension up to 40, 70 and 80mmHg just as in ABS, with an increase in CBV after destruction of the brain-stem. This study suggests that in many animals, ABS is not produced by small lesions produced in the brain-stem of animals with preexisting decreased cerebrovascular tone, as in this experiment However, in pathological intracranial conditions such as severe brain-stem compression ischemia and disturbance of the cerebrospinal fluid circulation with intracranial hypertension, ABS might be provoked by destruction of the cerebral vasomotor center in the brain-stem.No potential conflict of interest relevant to this article was reported.