岡山医学会Acta Medica Okayama0030-1558979-101985実験的脳梗塞gerbilにおける神経ペプチドと受容体結合に関する研究913925ENTakeshiKishimotoUnilateral occlusion of the right common carotid artery in adult gerbils produced right homolateral cerebral ischemia and neurologic deficits (stroke) in 41.4% (Group S). The other 58.6% of the gerbils did not develop signs of stroke (Group N). Brains from gerbils of both groups were analyzed for levels of 8 immunoreactive neuropeptides and 4 CNS-receptor bindings. The level of β-endorphin was 90% higher in the ischemic right hemisphere than in the control left hemisphere, although the levels of the other 7 neuropeptides, i.e., Met-enkephalin (ENK), dynorphin, thyrotropin releasing hormons (TRH), cholecystokinin-oktapeptide, substance P, somatostatin and vasoactive intestinal polypeptide (VIP), were not different between the two hemispheres. However, the dynorphin level in the right hemisphere of Group S was significantly lower than that in the right hemisphere of Group N. Opioid receptor bindings were significantly lower in the ischemic hemispheres than in the control hemispheres. On the other hand, ischemia did not produce any change in TRH receptor binding and VIP receptor binding in the brain. An intraperitoneal (i.p.) injection of the opiate antagonist naloxone (1mg/kg) reversed signs of stroke within 3-5 min in 20 of 20 Group S gerbils; the effect lasted for up to 20-30 min, after which stroke returned. Remarkably, 16 of 22 Group N gerbils injected i.p. with pentazocine (15mg/kg) 5 hr after ligation developed stroke within 10min. The pentazocine-induced stroke could be reversed by an i.p. injection of naloxone (10mg/kg). Injection of an enkephalin analogue (FK33824; 15mg/kg, i.p.) 5 hr after ligation also produced stroke in 14 other Group N gerbils. Without medication, all of the stroke gerbils died with in 12 to 28 hours, but with a subcutaneous implantation of a 10-mg pellet of naloxone, 20% of the gerbils lived for 4 weeks. These findings suggest that β-endorphin and opioid receptors may be involved in the pathophysiology of stroke.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985家兎およびヒトリンパ節の微細血管構築の走査電子顕微鏡的研究889912ENTakashiUsuiCorrosion casts of rabbit and human lymph nodes were observed by SEM. Casts showed a broad bean appearance. On the outer surface of casts, the afferent and efferent vessels and the vessels of the capsule were seen. Cross-sectioned surfaces of the casts showed a marked difference between the architecture of the cortex and the medulla. The casts of primary nodules appeared as small roundish capillary networks. The casts of secondary nodules formed spheres, inside of which there were poor capillaries. Secondary nodules showed many transitions. Pseudo-nodules appeared as egg-like, large capillary networks and included secondary nodules. The capillaries in diffuse lymphoid tissue anastomosed with the PCV. The PCV, which ran deeply into the cortex, anastomosed with the veins of the medulla in the cortico-medullary junction. The capillaries of medulla anastomosed directly with the veins of the medulla. Basically, the elements and arrangements of the vascular casts of the rabbit lymph node were similar to those of the human lymph node.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985担癌マウスにおける肝メタロチオネインの増加について871887ENShinKimotoThe amount of metallothinoein was examined in mice after Ehrlich-tumor-cell implantation. The amount of hepatic metallothionein in tumor-bearing mice increased 10-fold 7 days after tumor implantation as compared with control mice. Actinomycin D administration inhibited zinc uptake into liver and hepatic metallothionein synthesis induced in tumor-bearing mice. The increase in hepatic metallothionein content did not appear earlier than 6 days. In other tissues and tumor, an increase in metallothionein content was not observed for 7 days after tumor implantation. However, in tumors from zinc- or cadmium-loaded, tumor-bearing mice, an increase in metallothionein content was observed. The zinc level in the serum of tumor-bearing mice gradually decreased, and the zinc content was one half of the control content 7 days after implantation. Actionmycin D administration inhibited the decrease in serum zinc content. The zinc content of liver was increased as compared with control mice 7 days after implantation, but in other tissues changes in zinc content were not observed. The corticosterone level in the serum of tumor-bearing mice increased 2.5 fold 7 days after implantation as compared with control mice.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985両側腹側海馬破壊による扁桃核キンドリングへの影響855870ENTakeshiNakatsuThe clinical relevance of Ammon's horn sclerosis in epilepsy has not been fully ellucidated. This study was designed to examine the effects of bilateral ventral hippocampal lesions (Ammon's horn + dentate gyrus) on the minimal electroconvulsive threshold (ECT) intensity, kindling rates and transference phenomenon in cats kindled from the amygdala (AM). Ten adult cats were used. In the first experiment, lesions were made electrolytically in the bilateral hippocampi after completion of the primary site (PS) kindling from the left AM. Subsequently, the right AM (secondary site: SS) was kindled. In the second experiment, the hippocampal lesion was made prior to the PS-kindling which was followed by the SS-kindling. In the first experiment, the ECT intensity was unchanged by the hippocampal lesions after PS-kindling. The seizure pattern and EEG pattern in the generalized convultion were changed to show an asymmetrical, asynchronous pattern by the lesions. Facilitation of SS-kindling following the PS-kindling (positive transfer) was diminished by the lesions. In the second experiment, the formation of hippocampal lesions prior to the kindling retarded the PS kindling rates slightly. The seizure pattern and EEG pattern of the generalized convulsion was asymmetrical and asynchronous. In addition, positive transfer from PS to SS was blocked by the lesions. These results indicate that the ventral hippocampal formation and hippocampal commissure may be critical brain sites for the establishment of the transference phenomenon that reflects secondary epileptogenic changes in the brain.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985気管支喘息の臨床病型と温泉プール水泳訓練の効果849854ENYoshiroTanizakiSwimming training in a hot spring pool was carried out with 30 patients with bronchial asthma including 22 cases with steroid-dependent intractable asthma. Improvement in ventilatory function after 3 months of swimming training was compared among three asthma types, 1-a, 1-b and 2, classified accoridng to clinical symptoms. The ventilatory function test before the training showed that the mean value of FEV(1.0%) was less than 70% in all asthma types, indicating obstruction of the airways, and that the values of % FVC, % MMF, % V(50) and % V(25) of type 2 (bronchiolar obstruction type) asthma cases were significantly lower compared to those of type 1-a (bronchospasm type) and type 1-b (bronchospasm + hypersecretion type) asthma cases. After the 3-month training, type 1-a asthma cases showed an increase in FEV(1.0%) accompanied by an increase in % MMF, % V(50) and % V(25). An increase in % MMF, % V(50) and % V(25) with less increase in FEV(1.0%) was observed in type 2 asthma cases. In type 1-b, the mean increase in all parameters indicating obstruction of the airways was very low even in the cases whose symptoms were improved by the training.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985精神疾患におけるDSTの臨床的意義833848ENKoichiNishimonThe dexamethasone suppression test (DST) is considered to be a useful diagnostic test for hypothalamic-pituitary-adrenal (HPA) dysfunction in depression, but substantial doubt remains about its specificity. In this study, 21 healthy controls and 238 patients underwent the DST. The clinical diagnosis was made according to the Diagnostic and Statistical Manual for Mental Disorders, 3rd Edition (DSM-III). The specificity of the DST to endogenous depression was not as high as Carroll et al. reported, and the DST did not distinguish significantly between diagnostic categories of depression and schizophrenic disorders. The DST was a state dependent biological marker of the severity of symptoms including psychotic features in endogenous depression and schizophrenic disorders. The DST results indicated remarkable abnormality (post-dexamethasone cortisol level and DST positivity) in major depression with psychotic features, suggesting marked HPA dysfunction. Differential diagnosis is sometimes difficult between paranoid disorders in the aged and major depressive episodes with psychotic features. Nevertheless the DST should be useful in their differentiation, since the former disorder usually shows normal DST results. Accordingly, it was concluded that the DST could be used as a supplementary test in the study of various mental disorders and could be a valuable guide to the psychiatrist in combination with other biological markers.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985放射線治療を施行した原発性肺癌患者における血清フェリチン値の臨床的評価 ―血清CEA値と比較して―823831ENIzumiTogamiYoshioHirakiShinKimotoToshiakiShirakamiHiroyukiUedaNobuoSatohTetsuyaNakamuraHiromichiYamamotoIkuoJojaKeijiHashimotoSetsuoMorimotoKanameAonoYoshihiroTakedaSerum ferritin and serum carcinogenic embryonic antigen (CEA) levels in 153 patients (male: 112, female: 41) with primary lung cancer were simultaneously measured and compared with the histological type, clinical stage and clinical course. No correlation between serum ferritin and CEA levels was found. A higher percentage of positive test results for both serum ferritin and CEA was associated with advanced stages and metastasis in other organs. From the point of view of histological classification, high ferritin levels were mainly found in the patients with small-cell types of cancer. In contrast, high CEA levels were found in patients with adenocarcinoma. Therefore, the measurement of serum ferritin was not efficient as a screening test for lung cancer. Serum ferritin levels were, however, correlated with the efficacy of therapy and the clinical course.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985血液保存における中枢神経影響物質の変化に関する研究(第1編) ―血小板濃縮液の保存中におけるアンモニアの蓄積―815822ENAkioIshiiTo study how to control the ammonia level in platelet concentrates during storage, the effects of storage conditions on ammonia accumulation in the product were examined The ammonia level increased significantly with increasing storage temperature from 4℃ to 37℃ and reached approximately 500μmol/l after 72 hours of storage at 22℃. There was a negative relationship between the ammonia level and pH value of the product. The ammonia accumulation due to a fall in pH was depressed by applying a gentle flat-bed mode of agitation during storage. More vigorous agitation, such as elliptical agitation, resulted in higher ammonia accumulation. Analysis of changes in amino acids of the product showed that ammonia was mainly derived from non-enzymatic hydrolysis of glutamine in plasma. Glutamic acid had a preventing effect on the ammonia accumulation. The effect was dose-dependent and required approximately 50mg/dl final concentration to reduce the ammonia level to about half of the normal value. I consider the addition of glutamic acid to the blood preservative to be useful in reducing transfusion reactions due to ammonia.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985磁気共鳴画像による悪性リンパ腫の診断805814ENIkuoJojaYoshioHirakiHiroyukiUedaTetsuyaNakamuraYoshioYamamotoMitumasaKajiIzumiTogamiHarutakaNiiyaToshiakiShirakamiHidehiroHayashiShinKimotoKanameAonoKatsuhikoSugitaHiroshiUeokaTaisukeOhnoshiIkuroKimuraMagnetic resonance imaging (MRI) of pathological lymphnodes was reviewed in 12 patients with malignant lymphoma. We examined the characteristics of the images and T(1) values of lesions. Short SE was the most appropriate pulse sequence to delineate the lesions. It was intermediate in signal intensity between that of skeletal muscle and that of fat tissue. On IR image, the signal intensity of skeletal muscle or lung tissue was similar to that of lymphnodes, and on long SE image, that of fat tissue was similar to that of lymphnodes. It was difficult to differentiate Hodgkin's disease (HD) from non Hodgkin's lymphoma (NHL) using only T(1) values. The long SE signal intensity of the latter was higher than that of the former. The distribution of NHL was wider than that of HD. Though MRI has various problems such as long scan time and respiratory motion artifacts, it has various merits which other methods do hot have. We consider MRI to have an important role in the diagnosis and follow up of patients with malignant lymphoma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558979-101985頭蓋外―頭蓋内動脈吻合術における脳循環動態に関する実験的研究783803ENYujiYamamotoIn order to evaluate extracranial-intracranial arterial anastomosis in acute ischemic stroke, changes in the local cerebral blood flow (lCBF) in the cortical and subcortical areas were investigated by hydrogen clearance during left middle cerebral artery (MCA) occlusion and maxillary artery (MA)-to-MCA anastomosis in 24 mongrel dogs. Following MCA occlusion, the lCBF was maintained at more than 25ml/100g/min in 17 dogs because of effective leptomeningeal collaterals. In seven dogs, cortical ischemia was shown with progressive lCBF reduction to below 25ml/100g/min. Severe persistent ischemia of less than 10ml/100g/min was not observed. Subcortical ischemia with lCBF reductions to below 25ml/100g/min in the gray matter and below 10ml/100g/min in the white matter occurred more frequently than cortical ischemia. Following MA-MCA anastomosis, the cortical lCBF returned to nearly the preocclusion value, and the subcortical lCBF showed a slight or moderate increase. Reactive hyperemia was noted in two dogs (at three sites), but marked hyperemia was not abserved in any of the animals. The increase in the lCBF after the anastomsis showed a linear relationship to the donor arterial supply. Postmortem and histological examinations revealed no cerebral edema or hemorrhagic infarct. Comparative analyses of these results with the concept of "ischemic penumbra" led to the conclusion that cerebral ischemia with the cortical lCBF ranging from 15 to 25ml/100g/min (30 to 50% of the preocclusion value) after MCA occlusion cannot be reversed even by the leptomeningeal collaterals and may produce progessive neurological dysfunction. In such an ischemic condition, rapid restoration of the lCBF by extracranial-intracranial arterial anastomosis might be effective in the prevention of cerebral infarction as well as in the recovery of neuronal function.No potential conflict of interest relevant to this article was reported.