2024-03-29T13:21:49Zhttp://ginmu.naramed-u.ac.jp/dspace-oai/request
oai:ginmu.naramed-u.ac.jp:10564/10952017-06-11T23:20:26Zhdl_10564_1477表紙、目次、総目次、投稿規程詳細、奥付(Vol.60 No.5-6)表紙目次総目次投稿規程詳細奥付奈良医学会奈良県立医科大学2010-08-19T05:23:46Z2010-08-19T05:23:46Z2009-12-31OtherOthers4117555 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-613450069http://hdl.handle.net/10564/109513450069AA11252383Journal of Nara Medical Association605-6jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/10962017-05-29T06:07:33Zhdl_10564_1477担癌患者に見られる脳梗塞ISCHEMIC STROKE IN CANCER PATIENTS川原, 誠上野, 聡cerebral infarctionstrokecancernonbacterial thrombotic endocarditis脳梗塞の原因として悪性腫瘍は非常に重要であり,担癌患者に見られる脳梗塞は
大きく三つに分類される.第一に腫瘍自身による圧迫や閉塞,第二に血小板や凝固機能異常を
介した血管閉塞,第三に化学療法や放射線療法などの治療に合併する脳梗塞である.それぞれ
の診断の要点と特徴について簡単にまとめた.担癌患者における脳梗塞は,各ステージで様々
な原因が重畳してくるため,非常に複雑な病態を形成しており,正確な診断と各科連携による
総合的な治療方針の決定が必要である.奈良医学会奈良県立医科大学2010-08-19T05:32:47Z2010-08-19T05:32:47Z2009-12-31ArticleDepartmental Bulletin Paper2303139 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.123-13513450069http://hdl.handle.net/10564/109613450069AA11252383Journal of Nara Medical Association605-6123135jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/10972017-05-29T06:07:33Zhdl_10564_1477細胞の変性と死DEGENERATION AND DEATH OF CELLS中村, 忍cell degenerationcell deathapoptosisoncosisnecrosis細胞は老化,あるいは物理的,化学的な傷害によって変性を起こすが,変性が進
行し不可逆的な変化が生じた時点で死に至り,この後は死後の変化を辿る。この一連の過程が
どのようなものであるか,未だ明らかになっていない。約半世紀以前から細胞採取法の開発が
進み,これにより病変部位から新鮮な状態で細胞を得ることが可能になり,変性した細胞に基
づいて作成された癌細胞の診断基準では判定しきれなくなってきた。細胞の変性過程を理解す
ることは,臨床上,良,悪性細胞の診断を行う細胞診にとって極めて重要なことである。この
ような観点から細胞の変性過程を実験的に観察するとともに,細胞死についても検討を行った。
その結果,新鮮な癌細胞では,これまで重要な判定基準であった核クロマチンの粗剛化は見ら
れず,変性とともに出現することが分かった。細胞質と核の変性速度を比較すると,腺癌細胞
では細胞質の変性が核の変性に比較して速く,一方扁平上皮癌細胞では逆の結果であった。良
性細胞の変性速度は癌細胞に比較して速く,細胞種により細胞質と核の変性速度に差異がみら
れた。生理的にあるいは突発的に起こる細胞死の形態学的観察では,細胞の自殺であるアポト
ーシスと事故死に相当するオンコーシスについて,実験結果を基に概説した。とくに色素排泄
試験を用いた細胞死の検討では,色素排泄能の消失とともに細胞質の膨化が観察され,オンコ
ーシスは細胞死を表す変化のひとつであると考えられた。細胞の変性,死,および死後の変化
を理解するためには,丹念な形態学的観察が必要であることを強調した。奈良医学会奈良県立医科大学2010-08-19T05:41:43Z2010-08-19T05:41:43Z2009-12-31ArticleDepartmental Bulletin Paper8886892 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.137-14813450069http://hdl.handle.net/10564/109713450069AA11252383Journal of Nara Medical Association605-6137148jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/10982017-06-11T23:20:26Zhdl_10564_1477NON-ALCOHOLIC STEATOHEPATITIS IN NARA MEDICAL UNIVERSITY HOSPITAL BETWEEN 2003 AND 2008 ; RETROSPECTIVE STUDY WITH CLINICOPATHOLOGIC ANALYSISKongkarnka, SarawutKasai, TakahikoUemura, MasahitoFukui, HiroshiNonomura, Akitakasteatohepatitismetabolic syndromehepatocyte ballooningMallory bodiesperivenular/pericellular fibrosislipogranulomaClinical and pathological features of 50 Japanese patients with biopsy proven
non-alcoholic steatohepatitis (NASH) were reviewed. Incidence of NASH patients
increased gradually after 2004, up to 8.06% in the series of liver biopsy specimens.
Twenty-six were male and twenty-four were female with a mean age of 54.66 years
(range 19-80 years old, male: 47.5, female: 62.4 years old). Forty-four percent of patients
were preobese with a body mass index (BMI) between 25 and 30, while 28% of the
patients were non-obese, and only 28% of the cases were morbidly obese, confirming that
Japanese have a greater tendency to develop fatty liver disease than Western people.
Dyslipidemia was found in 30%, diabetes mellitus in 34%, and hypertension in 26% of the
patients. Abnormally elevated liver function tests were found in up to 90% of the
patients and were characteristically mild with 2- to 3- fold elevation from the normal
range in the majority of cases. Histological features of the liver were similar to those
reported in Western literature; steatosis was found in every patient and most of them
were score 1 (34%) and preferential macrovesicular in type. Lobular necroinflammation
was typically mild (combined stage 1 and stage 2,98%). Ballooned hepatocytes were
frequently observed with characteristic small poorly formed Mallory bodies. Pericellular
fibrosis, one of the key histologic features of NASH, was classified in stage 1 in the
majority of the patients (54%), with characteristic acinar zone 3 involvement. As for the
disease progression, portal fibrosis and/or bridging fibrosis could develop leading to
liver cirrhosis (stage 4 NASH) in 10% of the patients.奈良医学会奈良県立医科大学2010-08-19T05:48:48Z2010-08-19T05:48:48Z2009-12-31ArticleDepartmental Bulletin Paper12773886 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.149-15813450069http://hdl.handle.net/10564/109813450069AA11252383Journal of Nara Medical Association605-6149158engpublisher
oai:ginmu.naramed-u.ac.jp:10564/10992017-06-11T23:20:26Zhdl_10564_1477EFFECTS OF QIGONG IN TAI CHI IN THE ELDERLY USING GENERAL HEALTH QUESTIONNAIRE (GHQ)Wang, WenchaoSawada, MasayukiNoriyama, YoshinobuArita, KeisukeOta, ToyosakuKishimoto, ToshifumiQigongTai ChiGeneral Health Questionnaireelder; depressionquality of lifeObjectives : Previous studies have shown health benefits of Tai Chi, including
Qigong exercises. This study investigated the effects of Qigong in Tai Chi with elderly
volunteers using the General Health Questionnaire (GHQ).
Methods : Eighty-five participants were voluntarily recruited by posters; the present study
enrolled 49 healthy participants and randomized them to either the Tai Chi with Qigong
group (N=25) or the Tai Chi without Qigong group (N=24). We administered 24-style Tai
Chi once a week over 3 months to the participants. We measured GHQ scores of the
participants both at the baseline and at the end of the study.
Results : In the Tai Chi with Qigong group, GHQ total score, somatic symptoms score,
anxiety/insomnia score, and severe depression score at the end of the study were
significantly lower than those at the baseline. In the Tai Chi without Qigong group, GHQ
total scores and anxiety/insomnia scores at the end of the study were significantly lower
than those at the baseline. Mean change scores from baseline to endpoint in GHQ total
scores, and severe depression scores in the Tai Chi with Qigong group were significantly
greater than those in the Tai Chi without Qigong group. In the time courses of GHQ total
score and severe depression score, significant effects of interaction between group and
time were found.
Conclusion : The present study suggested that Qigong of Tai Chi exhibit significant bene-
fits for depressive symptoms in the elderly.奈良医学会奈良県立医科大学2010-08-19T05:55:11Z2010-08-19T05:55:11Z2009-12-31ArticleDepartmental Bulletin Paper671525 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.159-16513450069http://hdl.handle.net/10564/109913450069AA11252383Journal of Nara Medical Association605-6159165engpublisher
oai:ginmu.naramed-u.ac.jp:10564/11002017-05-29T06:07:33Zhdl_10564_1477外反母趾に対する水平骨切り術後における第1中足骨回内変形の矯正POSTOPERATIVE CORRECTION OF FIRST METATARSAL PRONATION DEFORMITY FOR HALLUX VALGUS成川, 功一田中, 康仁hallux valguspronationmapping, sesamoidThe foot with hallux valgus has pronation deformity in the first ray. To
clarify the necessity of a supination osteotomy for pronation correction, we investigated
76 feet in 48 patients with moderate to severe hallux valgus treated with newly devised
horizontal osteotomies, which have no potential for pronation correction. Preoperative
and postoperative pronation deformities in the first ray were analyzed using
radiographies. A mapping study showed that the first metatarsal head was moved in a
lateral direction by an average of 16% after the horizontal osteotomy and reducted onto
the sesamoids. The most frequent sesamoid position, as classified according to the
grading system of Hardy and Clapham, was Ⅶ before surgery and Ⅳ after surgery.
Correction of the sesamoid position indicates supination of the proximal phalanx.
Concerning the type of hallux pronation using the classification of Okuda et al., angular,
intermediate and round shapes of the metatarsal head accounted for 0%, 21%, and 79%
before surgery and 59%, 20% and 21% after the surgery. The frequency of the angular
shape increased significantly, indicating supination of the first metatarsal head. Even
without performing pronation correction at the osteotomy site, consequently correction of
the pronation deforrnity of the first metatarsal was observed as well as of the proximal
phalanx. Reposition of the sesamoids caused reduction of the first metatarsal head. Our
results showed that supination osteotomy is not necessary for correction of pronation
deformities in hallux valgus surgery.奈良医学会奈良県立医科大学2010-08-20T01:01:23Z2010-08-20T01:01:23Z2009-12-31ArticleDepartmental Bulletin Paper1908143 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.167-17913450069http://hdl.handle.net/10564/110013450069AA11252383Journal of Nara Medical Association605-6167179jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/11012020-08-18T02:17:26Zhdl_10564_1477慢性C型肝炎の背景の下,肝原発悪性リンパ腫と肝細胞癌を発症し,剖検で4重癌と判明した一例AN AUTOPSY CASE OF SIMULTANEOUS QUADRUPLE CANCERS DURING THE FOLLOW-UP OF CHRONIC HEPATITIS TYPE C; MALIGNANT LYMPHOMA AND HEPATOCELLULAR CARCINOMA OF THE LIVER, TOGETHER WITH LUNG AND ESOPHGEAL CANCERS吉原, 慎佑高野, 将人森田, 剛平武田, 麻衣子榎本, 泰典笠井, 孝彦野々村, 昭孝malignant lymphoma (ML)hepatocellular carcinoma (HCC)squamous cell carcinoma (SCC)high grade intraepithelial neoplasiachronic hepatitis type CThis is a case report of a 74-year old female patient with simultaneous
quadruple cancers diagnosed at autopsy. The patient had been suffering from chronic
hepatitis C, diabetes mellitus and hypertension since the age of 40. During the follow-up
period of chronic liver disease, malignant lymphoma (ML) of the liver was found at age
66, and hepatocellular carcinoma (HCC) at age 68. ML was treated with chemotherapy
and HCC with radiofrequency ablation (RFA) therapy, but both tumos recurred. At age
74, the patient was readmitted to the hospital with complaints of abdominal fullness and
lower leg edema and was hospitalized. Various image examinations revealed ascites and
multiple lymph node swelling around the abdominal aorta and it was diagnosed as
recurrent ML. She died 5 months after hospitalization with multiple organ failure. At
autopsy, another two carcinomas in addition to recurrent ML and remnant of HCC,
squamous cell carcinoma (SCC) of the lung and high grade intraepithelial neoplasia (SCC
in situ) of the esophagus were found. Hepatic inflammation caused by chronic hepatitis
type C virus infection was probably a cause of HCC and ML. Additionally, her alcohol
intake and smoking might be a risk for the development of SCC in both lung and
esophagus. Cases with quadruple cancers are rare but the number of cases with multiple
cancers is increasmg nowadays along with elongation of life expectancy. Periodical health
check-ups will be required for aged people to find and treat a cancer earlier and to spend
a good life.奈良医学会奈良県立医科大学2010-08-20T01:06:38Z2010-08-20T01:06:38Z2009-12-31ArticleDepartmental Bulletin Paper2253863 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.181-18713450069http://hdl.handle.net/10564/110113450069AA11252383Journal of Nara Medical Association605-6181187jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/11022017-06-11T23:20:26Zhdl_10564_1477Colonic adenocarcinomaに発生したcolonic moruleの一例A CASE OF COLONIC MORULE WITH COLONIC ADENOCARCINOMA殿村, 晴栄榎本, 泰典山岡, 健太郎武田, 麻衣子笠井, 孝彦野々村, 昭孝morulecolonic adenocarcinomaWe report a case of colonic morules with colonic adenocarcinoma. A
69-year-old woman visited our hospital with the complaint of abdominal pain. The
examination showed lower abdominal tenderness and muscular guarding. Ultrasonogra-
phy and computed tomograpy showed inflanunatory change in the ileocecal region with
cecal diverticula and presence of ascites. Surgical therapy was performed under a
diagnosis of cecal perforation. The surgery revealed a cecal tumor which had ruptured.
Iliocecal resection combined with lymph nodes dissection (D2) and peritoneal lavage was
performed. Histopathological examination revealed that the cecal tumor showed well-
differentiated adenocarcinoma with morular structures composed of small, oval cells with
bland nuclei in a mulberry-like arrangement. On immunohistochemical examination, the
morule showed nuclear overexpression of β catenin and CDX2, cytoplasmic
overexpression of CD10, and no expression of cytokeratin 20. Correct pathological
diagnosis is important to avoid an erroneous diagnosis of adenosquamous carcinoma
because morules morphologically bear a striking resemblance to squamous metaplasia
but are morphologically and qualitatively quite different from squamous metaplasia. She
has survived for 1.5 years since the operation, and shows good QOL under the follow-up.奈良医学会奈良県立医科大学2010-08-20T01:11:22Z2010-08-20T01:11:22Z2009-12-31ArticleDepartmental Bulletin Paper1662288 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.189-19413450069http://hdl.handle.net/10564/110213450069AA11252383Journal of Nara Medical Association605-6189194jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/11032020-08-18T02:18:59Zhdl_10564_1477腋窩に発生したhibernomaの一例A CASE OF A HIBERNOMA ARISING FROM THE AXILLA井上, 和也森田, 剛平城戸, 顕朴木, 寛弥笠井, 孝彦野々村, 昭孝hibernomabrown fatliposarcomaThis is a case report of a hibernoma arising from the axilla. The patient, a
54-year-old Japanese man, visited our hospital with the complaint of painless tumor in
the left axilla. The size of the subcutaneous tumor was about 7 cm on palpation. On
Magnetic Resonance Imaging (MRI), both T1-weighted and T2-weighted images of the
tumor were homogenous high signal intensity, so we suspected lipoma. Subsequent MRI
examination, however, revealed a non-fat part in the tumor. Because the tumor grew
slowly, surgical therapy was performed to rule out malignancy. The resected tumor was
14 × 11 × 6cm in size and exhibited a greasy, brown cut surface. Histopathological
examination revealed multivacuolated brown fat cells with granular cytoplasm and small,
central nuclei intermixed with ordinary white fat cells. Although brown fat cells
somewhat resemble lipoblasts, nuclei of brown fat cells are small, non-atypical and
centrally located, and are characteristically distributed evenly through the tumor
unrelated to blood vessels. Vasculatures are relatively abundant. No mitosis and atypical
cells were detected. On immunohistochemical examination, brown fat cells showed
cytoplasmic expression of S-100, and no nuclear expression of MDM2. A diagnosis of
hibernoma was made. Correct pathological diagnosis is important to avoid an erroneous
diagnosis of well-differentiated liposarcoma because "Lipoma-like" subtypes morphologi-
cally bear a striking resemblance to well-differentiated liposarcoma, but hibernoma is a
benign tumor that does not recur with complete local excision. MDM2 immunostaining is
a useful adjunct in diagnosing well-differentiated liposarcoma. The patient has survived
for 3 months since the operation, and shows good QOL under the follow-up.奈良医学会奈良県立医科大学2010-08-20T01:16:31Z2010-08-20T01:16:31Z2009-12-31ArticleDepartmental Bulletin Paper1243044 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.195-19813450069http://hdl.handle.net/10564/110313450069AA11252383Journal of Nara Medical Association605-6195198jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/11042017-05-29T06:07:33Zhdl_10564_1477胆石イレウスの1例A CASE OF GALLSTONE ILEUS中辻, 直之八倉, 一晃越智, 祥隆吉田, 英晃gallstone ileuscholecystoduodenal fistulaGallstone ileus is a rare complication of cholecystolithiasis. We report a
case of gallstone ileus diagnosed preoperatively by abdominal computed tomography
(CT). A 57-year-old female was admitted to our hospital due to epigastric pain and
vomiting. She had a history of cholecystolithiasis. Abdominal plain X-ray showed niveau
and abdominal CT showed the presence of calcification round in shape (20mm in
diameter) in the small intestine and cholecystoduodenal fistula. Laparotomy was
performed under a diagnosis of gallstone ileus with cholecystoduodenal fistula. At
exploration, a stone packed in the ileum 50cm oral from the ileum end was found and a
wall-thickened gallbladder was found firmly adherent at the duodenum. We removed the
impacted stone from the intestine and performed cholecystectomy and placed an omental
patching after trimming the wall of the duodenum to close the cholecystoduodenal fistula.
The CT findings allowed a definitive diagnosis preoperatively in this case.奈良医学会奈良県立医科大学2010-08-20T01:20:39Z2010-08-20T01:20:39Z2009-12-31ArticleDepartmental Bulletin Paper2822152 bytesapplication/pdfJournal of Nara Medical Association Vol.60 No.5-6 p.199-20513450069http://hdl.handle.net/10564/110413450069AA11252383Journal of Nara Medical Association605-6199205jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/11052017-06-11T23:20:26Zhdl_10564_1477第129回奈良医学会 : 学会記事第129回奈良医学会学会記事奈良医学会奈良県立医科大学2010-08-20T01:29:21Z2010-08-20T01:29:21Z2009-12-31ArticleDepartmental Bulletin Paper302002 bytesapplication/pdfJournal of Nara Medical Association Vol.59 No.6 p.207-20913450069http://hdl.handle.net/10564/110513450069AA11252383Journal of Nara Medical Association605-6207209jpnpublisher