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2.
Y Shimazu 《Nihon Geka Gakkai zasshi》1990,91(10):1534-1547
The aim of this study is to evaluate in vivo the effect of branched chain amino acid (BCAA). Experimentally, hepatic energy production and protein synthetic rate were measured in gastrectomized rat which was infused BCAA postoperatively. Clinically, following indices were examined in prospectively randomized patients who underwent abdominal operation and were administered with conventional total parenteral nutrition keeping Calorie/N ratio about 150, including nitrogen balance, urinary 3-methylhistidine, retinol binding protein, B lymphocyte percentage and lymphocyte blastogenesis by phytohemagglutinin. Furthermore, plasma BCAA with their keto-analog level, Factor XIII and opsonic activity were determined in another group of patients who received full strength load of BCAA immediately after subtotal or total gastrectomy, in a controlled prospective randomized double-blinded manner. Results obtained from above mentioned measurements exhibited significant improvement by the administration of BCAA. From these findings, it is suggested that BCAA sustains energy-protein metabolism, supports immunocompetence and promotes wound healing under moderately stressed condition where catabolic response is physiologically compensated. 相似文献
3.
To clarify the pathophysiology of intermittent claudication in 37 patients with lumbar spinal stenosis, neural function was evaluated by examining somatosensory evoked potentials (stress-SEPs), and nerve action potentials (stress-NAPs) before and after walking stress. It was shown preoperatively that the stress-SEPs became abnormal immediately after walking in 31 of 37 patients. In seven of nine operated patients, the assessment clearly shows that SEPs had reverted to normal after surgery. The present method is noninvasive, simple in technique, painless, and safe, a procedure therefore that is useful as the initial step in the diagnosis and treatment of patients with lumbar canal stenosis. It also may help to differentiate neurogenic from vascular intermittent claudication. 相似文献
4.
Comparative study on the macroscopic and histopathological diagnosis of lymph node metastases in cancer patients 总被引:1,自引:0,他引:1
Macroscopic diagnosis for lymph node metastases was compared with histopathological diagnosis in 444 patients with carcinoma of the esophagus, stomach, colon, thyroid and breast. The former indicated lymph node metastases in 181 patients. In all of them, none or less than five node metastases were proven by routine histopathological diagnosis. Detailed histological study revealed lymph node metastases in 25 out of 263 patients with macroscopically negative nodes, the rate of false negative being 9.5 per cent. The study also demonstrated no lymph node metastases in 51 of 181 patients with macroscopically positive nodes. Three additional specimens were obtained from originally examined 693 lymph nodes and reexamined microscopically in these 51 patients. Involvement by cancer cells was detected in 9 nodes (1.3 per cent) in 8 patients. Metastases were found from additional specimens in 7 of 9 nodes, indicating that metastatic carcinoma had been overlooked in the remaining two nodes. Additional specimens or embedding-techniques were recommended in such cases as macroscopic metastases were strongly suspected or lymph vessel invasions were remarkable. In 24 patients with esophageal cancer, one to one correspondence was available in the analysis of macroscopic diagnosis. Seventy-eight out of 108 involved nodes were macroscopically judged as involved (sensitivity; 72.2 per cent), and 1166 out of 1260 nodes without macroscopical metastases were judged as cancer-free (specificity; 92.5 per cent). Overestimation of macroscopic diagnosis was due to thickened capsule, fibrosis, inflammation and enlargement in size more than 10 mm in diameter of the nodes. Underestimation was observed in case of nodes with metastatic area less than one-third and with smaller size less than 5mm in diameter. 相似文献
5.
Transganglionic transport of horseradish peroxidase-wheat germ agglutinin conjugate was used to study the central projection of primary afferent neurons innervating facial and intraoral structures. The examined primary neurons innervating the facial structures were those comprising the frontal and zygomaticofacial nerves and those innervating the cornea, while the primary neurons innervating the intraoral structures included those innervating the mandibular incisor and molar tooth pulps and those comprising the palatine nerve. The primary afferents innervating the facial structures project to the lateral or ventral parts of the trigeminal principal, oral and interpolar subnuclei, and to the rostral cervical spinal dorsal horn across laminae I through V, with a greater proportion being directed to the spinal dorsal horn. The primary afferents innervating the intraoral structures terminate in the dorsomedial subdivisions of the trigeminal principal, oral and interpolar subnuclei, and in laminae I, II, and V of the medial medullary dorsal horn, with a much denser projection being distributed to the rostral subnuclei. In addition to the above brain stem trigeminal sensory nuclear complex, they project to the supratrigeminal nucleus, caudal solitary tract nucleus, and paratrigeminal nucleus. These observations agree with previously reported data that the central projection of trigeminal nerve is organized in different manners for the facial and intraoral structures. Furthermore, the present findings in conjunction with our previous studies clarify that the central projection of primary afferents from the facial skin is organized in a clear somatotopic fashion and that the terminal fields of primary afferents from the intraoral structures extensively overlap in the brain stem trigeminal nuclear complex particularly in its rostral subdivisions. The central mechanism of trigeminal nociception is discussed with particular respect to its difference between the facial and intraoral structures. 相似文献
6.
Clinical characteristics of thrombotic microangiopathy following ABO incompatible living donor liver transplantation. 总被引:1,自引:0,他引:1
Ryohei Miyata Motohide Shimazu Minoru Tanabe Shigeyuki Kawachi Ken Hoshino Go Wakabayashi Yoko Kawai Masaki Kitajima 《Liver transplantation》2007,13(10):1455-1462
Thrombotic microangiopathy (TMA) may develop after living donor liver transplantation (LDLT), but the mechanism is not fully understood. We retrospectively analyzed all patients undergoing LDLT at our center, including TMA patients, to elucidate the clinical characteristics and presentation and to determine which patients have a higher risk of occurrence of TMA. In all, 57 adult patients were reviewed after LDLT at our institution. TMA was diagnosed by sudden and severe thrombocytopenia, followed by hemolytic anemia with fractionated erythrocytes in the blood smear. Clinical features were compared between the TMA group and the non-TMA group. Of the 57 patients, 4 were diagnosed with posttransplantation TMA. ABO blood group (ABO)-incompatibility, cyclophosphamide (CPA), and recipient blood group (type O) were closely correlated with the occurrence of TMA. Thrombocytopenia appeared 1 to 5 days before hemolytic anemia. Coagulative function markers stayed at the same level after TMA, while marked elevation was shown in fibrinolytic function markers such as plasminogen activator inhibitor type 1 (PAI-1). TMA occurred at a higher prevalence in ABO-incompatible graft recipients. Additional factors associated with ABO-incompatible transplantation, such as an overdose of immunosuppressants, may affect the likelihood of TMA. Sudden and severe thrombocytopenia presented before hemolytic anemia and the serum levels of PAI-1 correlated well with the clinical course of TMA. In conclusion, early recognition of thrombocytopenia and elevation of PAI-1 is crucial to diagnose TMA especially in ABO-incompatible LDLT. 相似文献
7.
Yasuo Ito Yoshihiko Nakazato Ryo Tomioka Naotoshi Tamura Kunio Shimazu 《Clinical neurology》2007,47(8):512-515
We present a suspicious case of central neurosarcoidosis that presented with progressive gait disturbance probably caused by central vestibular dysfunction. And this case showed elevated level of angiotensin converting enzyme (ACE) in the cerebrospinal fluid, compared with the average level of two cases with acute inflammatory demyelinating neuropathy syndrome and four cases of multiple sclerosis. A 33-year-old man was admitted to our hospital with chief complaint of a gait disturbance that had appeared 3 years prior to the admission. And the symptom had exacerbated in these 3 months. Except for the gait disturbance and positive Romberg's sign, no neurological abnormality was detected. The findings of the cerebrospinal fluid test supported the diagnosis of meningitis. An increased level of angiotensine converting enzyme was detected when compared with our previous samplings from two cases of Guillain Barré syndrome and four cases of multiple sclerosis. With T1 weighted imaging of brain MRI, a high intensity lesion with gadolinium enhancement was identified in the central gray matter of the midbrain. Scan of the chest confirmed bilateral hilar lymphadenopathy. Based on these findings and the patient's clinical course, central neurosarcoidosis was suspected. The patient's symptoms improved dramatically after the administration of corticosteroid. The enhancement of the central gray matter ameliorated, and the ACE level of the CSF was decreased to the level of the demyelinating disorders. 相似文献
8.
Rat cartilage tissue was found to produce two types of proteoglycan monomers distinguished by density gradient centrifugation under dissociative condition and with different molecular size (PG I and PG II) as observed in cultured rabbit costal chondrocyte and human cartilaginous tissues. The incorporation of 35S-sulfate and distribution of the molecular size of proteoglycan (PG) were studied to determine the differentiated phenotypes of chondrocyte in adjuvant induced arthritis of rats. The cartilaginous tissue from the acute inflammatory phase shows a low incorporation of 35S-sulfate into PGs but produce the same hydrodynamic size as that of the control. After that acute phase the incorporation recovered suggesting of a repair phase. But in the chronic phase both the incorporation and the produced hydrodynamic size of PGs were severely alternated. With our method this paper shows the drastic alternation about the cartilaginous properties of rat chondrocytes under these circumstances. 相似文献
9.
Twenty-four patients with poor risk factors underwent an extra-anatomic bypass operation for aortoiliac occlusive disease and subclavian steal syndrome. A femoro-femoral bypass was performed on 5 patients, an axillo-femoral bypass on 15, a subclavian-subclavian bypass on 2 and an ascending aorta-femoral bypass on 2. There was only one operative death and there were 2 late deaths (8.3%). The patients were 20 males and 4 females with a mean age of 69.3 years. Among risk factors, high age (70 year old) was present in half of the patients, ischemic heart disease in 9, and cerebral vascular disease in 8. Seventy-five percent of the patients were suffering from two or more dysfunctions. During the limited follow-up period from 8 to 94 months (mean 46.1 months) there was a 96% patency rate. We had good results using externally supported ring graft and by the administration of prostaglandin E1 and ticlopidine during the pre and postoperative period. 相似文献
10.
N. Furuya K. Kawano H. Shimazu 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》1976,25(5):447-463
Summary In decerebrate, unanesthetized cats, the brain stem was longitudinally cut at the midline from its dorsal to ventral surface with the cerebellum kept intact, eliminating neural interactions between the bilateral vestibular nuclei through the brain stem.Extracellular spike potentials of vestibular type I neurons identified by horizontal rotation were distinctly inhibited by contralateral vestibular nerve stimulation. This crossed inhibition was abolished by removal of the medial part of the cerebellum, indicating that the inhibition was mediated through the cerebellum. Neither aspiration of the flocculus on the recording side nor intravenous administration of picrotoxin eliminated transcerebellar crossed inhibition, suggesting that it is mediated through the cerebellar nuclei. When the fastigial, interposite and dentate nuclei were stimulated, inhibition of vestibular type I neurons was produced only from the contralateral fastigial nucleus. Cerebellocortical stimulation which inhibited fastigial type I neurons suppressed transcerebellar crossed inhibition. Effective sites for suppression of transcerebellar crossed inhibition were localized to lobules VI and VIIa in the vermal cortex on the side of labyrinthine stimulation.Intracellular recordings were made from type I neurons in the medial vestibular nucleus. Stimulation of the contralateral vestibular nerve and the contralateral fastigial nucleus produced IPSPs in these neurons with the shortest latency of 3.8 msec and 1.8 msec, respectively. The difference between these two latency values approximates the shortest latency of spike initiation of fastigial type I neurons in response to vestibular nerve stimulation. It is postulated that transcerebellar crossed inhibition is mediated through the fastigial nucleus on the side of labyrinthine stimulation. 相似文献