[Multi-center evaluation of DSM-III in Japan and the diagnosis of endogenous psychoses].
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Biomedical subjects
Publications and source records attributed to K Hanada.
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Modification of E-64 focused on the terminal agmatine for practical use led to some potent analogs which were successfully obtained by a stereoselective synthesis using D-tartaric acid as a starting material. Ep-475 (id. E-64-c), in which the agmatine was replaced by 3-methyl-butylamine, was found to react with the essential SH of papain in accord with the decrease of activity. [3H]Ep-475 was irreversibly incorporated into papain in an equimolar ratio. None of the analogs showed any effect on thiol enzymes other than proteolytic ones.
The role of intracellular calcium-dependent proteinase(s) has been investigated in intact rat muscle. When calcium ions were introduced into intact muscle in vitro with ionophore A23187, Z-line loss and concomitant release of alpha-actinin into the medium were observed. The calcium-induced release of alpha-actinin was not diminished in the muscle with in vivo-injection of a thiol protease inhibitor, E-64-c. Intramuscular concentrations of E-64-c were also measured after pulse labeling with [3H]E-64-c followed by subcellular fractionation. Most of the inhibitor was localized in the cytosol, not in the lysosome. Therefore, we conclude that cytosolic as well as lysosomal proteinases in muscle are not inhibited by the in vivo labeling of the protease inhibitor (10 mg/kg).
To assess whether surgical procedures have fulfilled patients' expectations, questionnaires were sent to 41 patients who had undergone surgical-orthodontic correction of skeletal Class III malocclusions. Ninety per cent of the patients answered that they were satisfied with the results in regard to their chief problems and 85% had improved masticatory function. A favorable change in appearance was recognized by 24 patients, whereas 15 patients noticed no major changes, and two were displeased with the changes. Patients' expectations were not always satisfied despite evident improvement by objective standards. Factors affecting their satisfaction with the results of the surgery are discussed.
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1. E-64 [L-trans-epoxysuccinyl-leucyl-amido(4-guanidino)butane] was found to be an active site directed irreversible inhibitor of all of the cysteine proteinases tested except clostripain, and not to affect other enzymes. Thus it seems to be a powerful selective inhibitor for cysteine proteinases in mammalian systems. 2. The very high rate of inactivation of some cysteine proteinases, including cathepsins B and L, allows the molarity of active enzyme to be determined by stoichiometric titration with E-64. This incidentally calibrates the rate assay of the enzyme in terms of molar concentrations. 3. Measurement of rates of reaction of E-64 and a number of optically active analogues with cathepsins B, H and L has given some insight into structure-activity relationships. Cathepsin H is far less reactive than the other enzymes, and generally cathepsins B and L have reactivities rather similar to each other with the epoxide inhibitors.
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Fifty cases of skeletal Class III malocclusion were analyzed by the tracings of presurgical and postsurgical cephalograms to evaluate the stability of the mandible a year after surgery. In 33 patients, the curved oblique osteotomy in the ascending ramus was used; the correction was made in the mandibular body for 17 patients by either the rectangular osteotomy or the sliding osteotomy. Minimal relapse was observed in all three procedures, with the least amount occurring after mandibular body ostectomy or osteotomy. The results were considered to be due to careful determination of the correct time for surgery in each patient to avoid skeletal relapse resulting in continued mandibular growth, prompt osseous healing at the surgical sites by providing close and tight bony contact between the segments, elimination of the effect of the major muscles of mastication, minimum alteration in the position of the posterior segment and trimming of the margin of the anterior segment to form a proper gonial angle, and a stable occlusion with maximum intercuspation and an adequate overbite. In addition, preoperative orthodontic treatment and extraoral traction of the mandible by chin cups were considered effective means to stabilize the post-operative occlusion.
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A curved oblique osteotomy in which the ascending ramus was cut obliquely on a curved line from its anterior border to the angle was used for the treatment of 29 patients with skeletal Class III malocclusion, and 16 other patients were corrected by either an ordinary body ostectomy or a sliding osteotomy in the first premolar region. Both curved oblique osteotomy and sliding osteotomy could easily be performed with a Stryker's reciprocating saw, and osseous healing at the sites of surgery was rapid as a large area of intimate bony contact between the segments was obtained. The resulting profile and skeletal changes studied by cephalograms were excellent, with no significant relapse, and recovery of a stable occlusion was attained. The combined approach with orthodontists which included thorough analysis of each patient, preoperative alignment of the dental arches and postoperative care was essential for obtaining the best results.
To overcome some of the disadvantages of the mandibular body ostectomy, a sliding osteotomy accomplished by parallel sectionings of the mandible in the regions of the first premolars was used for the treatment of mandibular prognathism in two cases. The osteotomy was performed by an intraoral approach without any damage to the contents of the mental foramen. The anterior segment could be moved back to any desirable position without losing optimum bony contact. An adequate blood supply to the anterior segment was maintained by a large area of periosteal attachment on the lingual side. The method is effective for correction of mandibular prognathism in which a good occlusion cannot be expected by a ramus osteotomy.