[Discussion: a learning experience at the 1st organizational activity study group at Yokohama].
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Biomedical subjects
Publications and source records attributed to K Tamura.
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The effects of a weak direct current and of silver ions on experimental osteomyelitis were studied. Electrical stimulation with stainless electrodes aggravates the osteomyelitis, especially at the positive electrode. But electrically generated silver ions inhibit the growth of bacteria not only in vitro but also in vivo, and electrical callus formation occurs on infected bone. A clinical study was undertaken based on these findings. We obtained a success rate of 12 out of 14 based on the total number of cases, of which eight had a previous history of known or suspected infection, and this method proved to be an effective means of treating infected non-union.
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The antiemetic effect of domperidone against nausea, vomiting, and anorexia induced by antineoplastic agents was compared with that of chlorpromazine. Twenty patients with malignant neoplasms given 2 cycles of a combination chemotherapy including cisplatinum and adriamycin received domperidone in one cycle and chlorpromazine in another cycle. Antiemetics 10-20 mg were given 30 minutes before chemotherapy and every 4-6 hours afterwards by div, iv, or po. No significant differences in severity of nausea and vomiting and duration of anorexia were noted between domperidone and chlorpromazine. Side effects were observed in 11 patients who received chlorpromazine, while none was observed in domperidone. It was concluded that domperidone was as effective as chlorpromazine as antiemetics and more useful because of its lower incidence of side effects. The antiemetic effect of domperidone, however, was not great enough for some patients, especially when they received cisplatinum. A higher dose of domperidone or domperidone with concomitant use of glucocorticoids should be considered as promising antiemetics for these patients.
Surgical treatments were performed in 88 cases of metastatic lung tumors, where 5 years survival rate in all resected cases was 37.5%. We report our principles on the surgical treatment for metastatic lung tumors. First of all, the biological characteristics of the primary lesion is among the most important factors in considering the indication for the surgical treatment in metastatic lung tumors. For example, chemotherapy must be the first choice in treating lung metastasis of choriocarcinoma, and hormone therapy in lung metastasis of mammary carcinoma. On the other hand, such tumors as osteogenic sarcoma, soft tissue sarcoma, colorectal carcinoma and Grawitz's tumor, should be treated by surgery. Another point in the surgery of the metastatic lung tumor is the choice of the mode of operation for the solitary metastatic tumor according to tumor type. As a principle, partial or segmental resection is preferably chosen for metastatic lung tumor. However, the location of the lung tumor, tumor size, hilar lymph node metastasis and the pattern of invasion to the surrounding lung tissue must be considered to decide the surgical procedure. From these considerations, the segmental or partial resection for metastatic sarcomas and the lobectomy for the metastatic carcinomas are appropriate in general.
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The urine levels of immunosuppressive acidic protein (IAP) were measured in patients with and without cancer, using passive hemagglutination inhibition test and 24-h urine samples. In 23 control healthy adults, the urine levels of IAP were 0.13-1.3 mg/day. If an elevation of IAP levels were found in 46 (48%) of 96 cancer patients. Elevated urine IAP levels were found in 6 (18%) of 34 patients with non-cancerous gastrointestinal tract diseases. Increased urine IAP was demonstrated in 11 (58%) of 19 non-cancer patients with rheumatoid arthritis.
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The association between primary hyperparathyroidism and previous irradiation was investigated in two study groups. Among 36 patients with hyperparathyroidism, 4 (11%) knew of having received radiation therapy. In the second group of 323 patients with a history of radiation exposure and nodular thyroid disease, 4 (1%), thus far, were found to have hyperparathyroidism.
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Glycogen aggregates in the cardiac muscle cell, which have been frequently demonstrated in endomyocardial biopsies under the transmission electron microscope, were studied using the optical microscope in order to clarify their histopathological significance in various heart diseases. The right ventricular muscle biopsies were obtained from the following 120 patients: 24 cases of congestive cardiomyopathy, 26 of hypertrophic cardiomyopathy, 28 of atrial septal defect, 6 of primary pulmonary hypertension, 31 of bradyarrhythmic hearts and 5 controls. The tissue specimens were fixed with glutaraldehyde and osmium tetraoxide, and embedded in epoxy resin. Semi-thin sections from these specimens were dyed with tribasic staining originated by KUROTAKI (1972). Under the optical microscope, glycogen is clearly identified by its forming red stained areas which are seen not only in the subsarcolemmal layers and the perinuclear region, but also in the intermyofibrillar zones. The glycogen aggregates are more frequently observed in the specimens from the atrial septal defects and the bradyarrhythmic hearts than in the other cases. Thus, observation of glycogen aggregates reveals notable differences in appearance depending on the kinds of diseases. In the bradyarrhythmic hearts, the glycogen aggregates can be more readily observed in specimens from younger patients than in elderly ones. Furthermore, the glycogen aggregates appear regardless of both the grades of hypertrophy and degeneration in myocardial cells. These results do not agree with previous reports that the occurrence of glycogen is proportional with the grade of cardiac cell hypertrophy and/or damage.
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