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Effect of age on urinary excretion of N-acetyl-beta-D-glucosaminidase. 年龄对尿中n -乙酰- β - d -氨基葡萄糖苷酶的影响。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.33
K Oba, M Hirai, Y Ajiro, K Okazaki, S Sato, K Sasai, T Suzuki, H Nakano, S Metori

To examine the relationship between the concentrations of urinary NAG and age, we measured ratios of urinary N-acetyl-beta-D-glucosaminidase (NAG) to urinary creatinine (NAG index) in 137 healthy subjects, aged from 19 to 88 years. The study is also designed to evaluate the relationship between urinary NAG and blood pressure. The subjects were divided into 7 subgroups, according to their age (< 30, 30-39, 40-49, 50-59, 60-69, 70-79, 80 or more years). There was a positive correlation between NAG index and age (r = 0.36; P < 0.001). The regression equation relating NAG index (y) to age (x) was y = 0.065x + 0.97. The mean NAG indexes for the 7 subgroups divided by age were significantly different (P < 0.01). There was a positive correlation between NAG index and systolic blood pressure (r = 0.18; P < 0.05), but was not between diastolic blood pressure and NAG index. In multiple regression analysis, age and BUN significantly correlated with NAG index (r = 0.32; P < 0.01, r = 3.3; P = 0.07, respectively), although there was no correlation between systolic blood pressure and NAG index. This cross-sectional study showed a clear elevation in NAG index with age. The rate of elevation was 0.65 per decade. Urinary excretion of NAG may be unrelated to blood pressure.

为了研究尿NAG浓度与年龄的关系,我们测量了137名年龄在19 ~ 88岁的健康受试者的尿n -乙酰- β - d -氨基葡萄糖苷酶(NAG)与尿肌酐(NAG指数)的比值。该研究还旨在评估尿NAG与血压之间的关系。按年龄分为7个亚组(< 30岁、30-39岁、40-49岁、50-59岁、60-69岁、70-79岁、80岁及以上)。NAG指数与年龄呈正相关(r = 0.36;P < 0.001)。NAG指数(y)与年龄(x)的回归方程为y = 0.065x + 0.97。按年龄划分的7个亚组平均NAG指数差异有统计学意义(P < 0.01)。NAG指数与收缩压呈正相关(r = 0.18;P < 0.05),而舒张压与NAG指数之间无显著差异。多元回归分析中,年龄、BUN与NAG指数显著相关(r = 0.32;P < 0.01, r = 3.3;P = 0.07),但收缩压与NAG指数无相关性。横断面研究显示NAG指数随年龄明显升高。海拔升高率为每十年0.65。尿中NAG的排泄可能与血压无关。
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引用次数: 11
[Metastatic brain tumor]. [转移性脑瘤]。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.56
F Yamaguchi, H Takahashi, A Teramoto
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引用次数: 16
Modified Fontan operation. Considerations for the determination of the appropriate procedure. 修改方探操作。确定适当程序的考虑因素。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.28
H Yamauchi, Y Ishii, H Omori, Y Takakusaki, K Yamada, T Yajima, T Nitta, M Ochi, D Fukumi, Y Kuramochi, T Okubo, S Ogawa, S Tanaka

Background: Although the surgical results of the modified Fontan operation continues to improve, there are various advantages and disadvantages in terms of the post operative condition associated with the Fontan modifications. Late morbidity and mortality are mainly due to arrhythmias, thromboembolic complications, systemic venous hypertension and infective endocarditis. We reported our experience of the modified Fontan operation to determine an appropriate procedure for each patient.

Methods and results: Seven patients (ranging from the age 1-14 years) underwent a modified Fontan operation including a lateral tunnel (n = 1), extracardiac conduit (n = 2) and autogenous atrial tunnel (n = 4). There was one hospital death due to sepsis in which the patient underwent lateral tunnel procedure. The mean follow up of another six patients was 20 months (ranging from 1-39 months) and all patients were classified as NYHA class I, and remained in normal sinus rhythm without any thromboembolic complications.

Conclusions: When using the autogenous atrial tunnel, there are potential advantages; it is not associated with thromboembolism or endocarditis and has growth potential. However, in high-risk patients with increased pulmonary vascular resistance, impaired ventricular function and pre-operative atrial arrhythmias, it appears reasonable to use an extracardiac conduit.

背景:虽然改良Fontan手术的手术效果不断改善,但在Fontan改良手术的术后条件方面存在各种优缺点。晚期发病和死亡主要是由于心律失常、血栓栓塞并发症、全身静脉高压和感染性心内膜炎。我们报告了我们改良Fontan手术的经验,以确定适合每位患者的手术方法。方法和结果:7例患者(年龄1-14岁)接受了改良的Fontan手术,包括外侧隧道(n = 1)、心外导管(n = 2)和自体心房隧道(n = 4)。有1例患者在接受外侧隧道手术后因败血症死亡。其余6例患者平均随访20个月(1 ~ 39个月),均为NYHA I级,窦性心律正常,无血栓栓塞并发症。结论:采用自体心房隧道有潜在的优势;它与血栓栓塞或心内膜炎无关,并具有生长潜力。然而,对于肺血管阻力增加、心室功能受损和术前心房心律失常的高危患者,使用心外导管似乎是合理的。
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引用次数: 1
Fibroin allergy. IgE mediated hypersensitivity to silk suture materials. 蚕丝蛋白过敏。IgE介导的丝缝线材料过敏。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.41
S Kurosaki, H Otsuka, M Kunitomo, M Koyama, R Pawankar, K Matumoto

Delayed-type hypersensitivity with granulomatous lesions to silk sutures is rather rare. Yet, braided silk sutures often act as a non-immunologic foreign-body and cause a granulomatous inflammatory reaction years after surgery. We report here a case of recurrent granulomas with remarkable infiltration of eosinophils that may have resulted from an IgE-mediated hypersensitivity reaction to silk fibroin, a component of the braided silk suture. Under normal circumstances exposure to fibroin is rather rare. Therefore, the present patient may have developed this reaction to the silk sutures used in a previous surgery.

丝缝线伴肉芽肿的迟发性超敏反应相当罕见。然而,编织丝缝合线经常作为非免疫性异物,并在手术后数年引起肉芽肿性炎症反应。我们在此报告一例复发性肉芽肿伴显著嗜酸性粒细胞浸润,可能是由ige介导的丝素(编织丝缝合线的一种成分)过敏反应引起的。在正常情况下,接触丝素是相当罕见的。因此,本例患者可能对先前手术中使用的丝缝合线产生了这种反应。
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引用次数: 98
[Induction of noradrenergic supersensitivity following cordotomy in neonatal rat spinal motoneurons]. [脊髓切开术诱导新生大鼠脊髓运动神经元去甲肾上腺素能超敏感]。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.21
H Kadotani

Patients with spinal cord lesions frequently show autonomic hyperreflexia. The mechanism of autonomic hyperreflexia has been thought to be an acute general autonomic overactivity in response to cutaneous or visceral stimuli, but it remains uncertain. Several kinds of experiments suggest that amplified spinal sympathetic reflexes in the decentralized cord are attributable to the denervation supersensitivity of denervated neurons, which is a well-known phenomenon in denervated muscle fibers. In the present study, changes in the supersensitivity of motoneurons after cordotomy were studied in the spinal cord of neonatal rats. Responses to bath-applied noradrenaline (NA) were recorded from a ventral root of the isolated spinal cord of 6-day-old rats. In normal spinal cords, NA induced depolarization in motoneurons dose-dependently. alpha 1-antagonist prazosin (3 microM) inhibited the deporalization induced by NA, and alpha 2-antagonist rauwolscine (1 microM) potentiated it. In one group of rats, cordotomy was performed 4 days after birth by complete transection of the spinal cord at vertebrate 8th-10th thoracic level, and NA response was examined two days later (when they were 6 days old). In cordotomized rats, NA-induced depolarization was increased with respect to both amplitude and duration. alpha 1- as well as alpha 2-antagonists inhibited the NA response in the spinalized rats. Especially, both antagonists shortened the duration of NA response as compared to normal level. It is concluded that the denervation supersensitivity to NA appears 2 days after cordotomy in the spinal motoneurons of neonatal rats and that the supersensitivity to NA is attributable to the upregulation of both alpha 1- and alpha 2-adrenoceptors on the motoneurons, indicating that a new type of alpha 2-adrenoceptor function appears.

脊髓病变患者常表现为自主神经反射亢进。自主神经反射亢进的机制被认为是对皮肤或内脏刺激的急性全身自主神经过度活动,但其机制仍不确定。多种实验表明,去中心化脊髓中增强的脊髓交感反射可归因于去神经支配神经元的超敏感,这是去神经支配肌纤维中众所周知的现象。本研究研究了新生大鼠脊髓切断后运动神经元超敏反应的变化。从6日龄大鼠离体脊髓腹侧根处记录对浴敷去甲肾上腺素(NA)的反应。在正常脊髓中,NA诱导运动神经元去极化呈剂量依赖性。α - 1拮抗剂prazosin (3 μ m)抑制NA诱导的脱卟啉,α - 2拮抗剂rauwolsciine (1 μ m)增强NA诱导的脱卟啉。一组大鼠在出生后第4天,通过在脊椎动物第8 -第10胸段完全横断脊髓进行脊髓切开术,并于2天后(6天大时)检测NA反应。在去皮质大鼠中,na诱导的去极化在振幅和持续时间上都有所增加。α 1-和α 2拮抗剂抑制脊髓化大鼠的NA反应。特别是,与正常水平相比,两种拮抗剂都缩短了NA反应的持续时间。由此可见,新生大鼠脊髓运动神经元在脊髓切断2天后出现去神经对NA的超敏感,对NA的超敏感与运动神经元上α 1-和α 2-肾上腺素受体的上调有关,表明出现了一种新型的α 2-肾上腺素受体功能。
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引用次数: 0
Spontaneous gastrointestinal perforation in patients with lymphoma receiving chemotherapy and steroids. Report of three cases. 接受化疗和类固醇治疗的淋巴瘤患者的自发性胃肠道穿孔。报告三例病例。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.37
M Wada, M Onda, A Tokunaga, T Kiyama, T Yoshiyuki, N Matsukura, K Furukawa, K Egami, K Yamashita

Spontaneous gastrointestinal perforations in three patients with lymphoma were considered to be treatment-related conditions. All three were diagnosed as having malignant lymphoma by histological examination, and treated with chemotherapy and steroids. Four to 14 days after the start of chemotherapy, they complained of abdominal pain and plain roentgenograms revealed pneumoperitoneum. The interval between the onset of peritonitis and operation was almost 24 h. Emergency operations were carried out; one patient with a jejunal perforation underwent resection of the jejunum, another with a gastric perforation received a simple closure with omental patch, and the third with a gastric perforation underwent gastrectomy. Two patients recovered from the surgery, while the gastrectomy patient died due to sepsis. The favorable outcome of the surgical intervention is attributed to early diagnosis, prompt exploration, and selective operative procedures. We recommended a simple closure with omental patch for gastroduodenal perforation. Resection and primary anastomosis are possible only in the small bowel.

自发性胃肠道穿孔3例淋巴瘤患者被认为是治疗相关的条件。3例患者均经组织学检查诊断为恶性淋巴瘤,并接受化疗和类固醇治疗。化疗开始后4至14天,患者主诉腹痛,x线平片显示气腹。腹膜炎发病至手术时间间隔近24小时,进行了紧急手术;一例空肠穿孔患者行空肠切除术,另一例胃穿孔患者行简单网膜补片封闭,第三例胃穿孔患者行胃切除术。两名患者从手术中恢复,而胃切除术患者因败血症死亡。手术干预的良好结果归功于早期诊断、及时探查和选择性手术。我们建议对胃十二指肠穿孔采用网膜补片进行简单闭合。切除和初次吻合只能在小肠中进行。
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引用次数: 36
Effects of temperature and preservation time on the pharmacological response of isolated vascular endothelial and smooth muscle function. 温度和保存时间对离体血管内皮和平滑肌功能药理反应的影响。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.15
H Iwaki, A Sakamoto, S Tanaka

In clinical transplantation and cardiovascular surgery, cold preservation is usually used because it is a simple method. However, the established temperature is by no means exact. The aim of this study was to find the optimum storage temperature for preservation of the vasculature by observing the pharmacological endothelium and smooth muscle response. The thoracic aorta of 36 male Wister rats were studied in organ baths: as fresh control after 24 hours, 48 hours and 72 hours of storage at 0.5 degree C, 4 degrees C and 8 degrees C in Krebs-Henseleit bicarbonate (KHB) solution. Acetylcholine (Ach) was used to elicit endothelium-dependent relaxation, and sodium nitroprusside (SNP) to elicit smooth muscle-dependent relaxation. The contractility caused by Phenylephrine (Ph) was influenced by time but before 48 hours it was not influenced by preservation temperature. Significant responsive deterioration by Ach and SNP was seen after 24 hours of storage at 0.5 degree C as compared with storage at 4 degrees C. The endothelium-dependent relaxing function and smooth muscle-dependent relaxing function were best preserved at 4 degrees C and 8 degrees C. These results indicate that precise temperature control is necessary for vessel preservation in clinical situations.

在临床移植和心血管手术中,由于其方法简单,通常采用冷保存。然而,所确定的温度决不是精确的。本研究的目的是通过观察血管内皮和平滑肌的药理反应,寻找保存血管的最佳贮藏温度。研究了36只雄性Wister大鼠的胸主动脉,分别在0.5℃、4℃和8℃的碳酸氢钠(KHB)溶液中保存24小时、48小时和72小时作为新鲜对照。乙酰胆碱(Ach)诱导内皮依赖性松弛,硝普钠(SNP)诱导平滑肌依赖性松弛。Phenylephrine (Ph)引起的收缩力受时间的影响,但在48小时前不受保存温度的影响。与4℃保存相比,在0.5℃保存24小时后,Ach和SNP的反应性下降明显。内皮依赖性舒张功能和平滑肌依赖性舒张功能在4℃和8℃保存得最好。这些结果表明,在临床上,精确的温度控制是血管保存的必要条件。
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引用次数: 5
[Treatments for vascular dementia and Alzheimer's disease]. [血管性痴呆和阿尔茨海默病的治疗方法]。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.52
S Kitamura
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引用次数: 1
[Clinical features and management of elderly patients with dementia]. 【老年痴呆患者的临床特点及处理】。
Pub Date : 1999-02-01 DOI: 10.1272/jnms.66.49
M Kimura
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引用次数: 0
[DNA bend sites in the promoter region of the human estrogen receptor alpha gene]. [人类雌激素受体α基因启动子区域的DNA弯曲位点]。
Pub Date : 1998-12-01 DOI: 10.1272/jnms1923.65.459
K Kuwabara, Y Sakuma

DNA bend sites in the promoter region of the human estrogen receptor a gene were determined by the circular permutation assay. Among a total of five sites (ERB -4 to -1, and ERB + 1) mapped in the 3 kb region, three matched with the positions of the predicted periodicity while the other two did not. Most of the sites were accompanied by the short poly (dA)-poly (dT) tracts including the potential bend core sequence A2N8A2N8A2 (A/A/A). Fine mapping of the ERB-2 site indicated that this A/A/A and the immediate franking sequences contained motifs for the estrogen response element. This region had a higher affinity for the nuclear scaffold and was included in the core region of the nucleosome structure. However, binding of the nuclear factor(s) to the motifs and disruption of nucleosome structure occurred without ATP. These results suggest that a class of periodic bent DNA could act as a site of multiple interactions among the nuclear scaffold, core histones and nuclear factors.

用环形排列法测定了人雌激素受体a基因启动子区的DNA弯曲位点。在3kb区域共定位了5个位点(ERB -4 ~ -1和ERB + 1),其中3个位点与预测周期的位置匹配,另外2个位点与预测周期的位置不匹配。大部分位点均伴有短聚(dA)-聚(dT)链,包括潜在弯曲核序列A2N8A2N8A2 (A/A/A)。对ERB-2位点的精细定位表明,该A/A/A和直接标记序列包含雌激素反应元件的基序。该区域对核支架具有较高的亲和力,位于核小体结构的核心区域。然而,核因子与基序的结合和核小体结构的破坏在没有ATP的情况下发生。这些结果表明一类周期性弯曲DNA可能作为核支架、核心组蛋白和核因子之间多重相互作用的位点。
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引用次数: 0
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