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oai:ginmu.naramed-u.ac.jp:10564/7052017-06-11T23:20:26Zhdl_10564_1498表紙、目次、投稿規定、奥付(Vol.47 No.2)表紙目次投稿規定奥付奈良医学会2009-01-14T00:57:08Z2009-01-14T00:57:08Z1996-04-30OtherOthers269594 bytesapplication/pdf奈良医学雑誌 Vol.47 No.20469555013450069http://hdl.handle.net/10564/70504695550AN00180974奈良医学雑誌472jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/7062017-06-11T23:20:26Zhdl_10564_1498A CASE OF FOCAL GLOMERULOSCLEROSIS ASSOCIATED WITH CYSTINURIAKanauchi, MasaoShiiki, HideoFujii, YoshihiroDohi, KazuhiroFutami, TakashiHirao, YoshihikoOkajima, Eigorocystinuriafocal glomerulosclerosisnephrotic syndrometioproninWe report a case of cystinuria in which the nephrotic syndrome developed
during treatment with tiopronin (alpha-mercaptopropionylglycine). Light microscopy of
renal biopsy specimen showed focal glomerulosclerosis. Proteinuria resolved after withdrawal of the drug and without corticosteroid administration. The pathogenesis of tiopronin-induced nephropathy and this unusual presentation of symptoms are discussed with
respect to the literature.奈良医学会2009-01-14T01:03:13Z2009-01-14T01:03:13Z1996-04-30ArticleDepartmental Bulletin Paper1495934 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.129-1330469555013450069http://hdl.handle.net/10564/70604695550AN00180974奈良医学雑誌472129133engpublisher
oai:ginmu.naramed-u.ac.jp:10564/7072017-05-29T06:07:08Zhdl_10564_1498胎便吸引症候群30例の臨床的検討 : 合併症の発現頻度と発現時期を中心にA STUDY OF 30 CASES OF MECONIUM ASPIRATION SYNDROME : ON THEIR INCIDENCE AND TIMING OF COMPLICATIONS宮里, 馨西久保, 敏也村上, 智彦田中, 采永子島本, 太香子一條, 元彦橋本, 和子高橋, 幸博吉岡, 章meconium aspiration syndromepulmonary air leakpersistent pulmonary hypertention of the newbornhypoxic ischemic encephalopathyThirty cases of meconium aspiration syndrome (MAS) were analyzed as to
their clinical features and the incidence and timing of 3 major complications, i. e.,
pulmonary air leak, Persistent pulmonary hypertension of the newborn (PPHN), and
hypoxic ischemic encephalopathy (HIE). The following results were obtained.
1. Of the 30 cases, 18 (60%) developed at least one of the three complications. These
complications often developed within 30 hours after birth.
2. Pulmonary air leak occurred in 11 cases. It developed within 4 hours after birth in 6
cases and approximately 24 hours after birth in 4 cases.
3. PPHN developed in 6 cases. In 4 of these 6 cases, PPHN followed or preceded air
leak.奈良医学会2009-01-14T01:09:27Z2009-01-14T01:09:27Z1996-04-30ArticleDepartmental Bulletin Paper477022 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.134-1380469555013450069http://hdl.handle.net/10564/70704695550AN00180974奈良医学雑誌472134138jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/7102017-05-29T06:06:27Zhdl_10564_1498巨大な肝腫大と興味ある腹部CT・MRI画像を呈した原発性アミロイドーシスの1例PRIMARY AMYLOIDOSIS WITH HEPATOMEGALY AND INTERESTING FINDINGS OF ABDOMINAL CT AND MRI : A CASE REPORT中川, 義仁椎木, 英夫西野, 俊彦藤本, 眞一藤井, 謙裕土肥, 和紘植村, 正人小嶌, 秀之福井, 博辻井, 正廣橋, 伸治hepatomegalyMRIprimary amyloidosisWe report a 51-year-old woman with primary amyloidosis as a case demon-
strating the diagnotic usefulness of Magnetic Resonance Imaging (MRI). The patient was
admitted to our hospital for further evaluation of nephrotic syndrome. Renal biopsy showed
deposition of AL amyloid in the mesangial area and along the capillary wall.
An abdominal computed tomographic (CT) scan revealed huge hepatomegaly accompanied
by unhomogeneous enhancement. On MRI, T2-weighted image showed significantly
reduced intensity in the spleen, while it was mildly reduced in the liver, suggesting massive
deposition of amyloid protein in the spleen. The combination of MRI and CT scans is a
useful tool for diagnosis of primary amyloidosis.奈良医学会2009-01-14T01:49:36Z2009-01-14T01:49:36Z1996-04-30ArticleDepartmental Bulletin Paper1332000 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.139-1440469555013450069http://hdl.handle.net/10564/71004695550AN00180974奈良医学雑誌472139144jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/7112017-05-29T06:07:08Zhdl_10564_1498エキシマレーザー照射による角膜の組織学的変化に関する実験的研究CORNEAL HISTOPATHOLOGICAL CHANGES AFTER EXCIMER LASER ABLATION IN RABBITS AND PORCINE EYES名和, 良晃excimer laserkeratorefractive surgerycorneal pathologyThe present paper reports the investigation of corneal histopathological
changes after excimer laser ablation in rabbits and fresh porcine eyes. In the ablated area,
there are thickening of the epithelium, discontinuous basement membrane of the basal
epithelial cells, and scarring of the superficial stroma. These changes are especially marked
in severely ablated corneas, but they become less marked as time passes by. Linear
electron-dense material is present in Descemet's membrane even in clinically weakly
ablated eyes.奈良医学会2009-01-14T01:56:45Z2009-01-14T01:56:45Z1996-04-30ArticleDepartmental Bulletin Paper3905345 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.145-1540469555013450069http://hdl.handle.net/10564/71104695550AN00180974奈良医学雑誌472145154jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/7122017-05-29T06:06:28Zhdl_10564_1498血中エンドトキシン測定のための新しい血漿処理法の開発とその臨床的意義 : 肝疾患における検討DEVELOPMENT OF NEW TREATMENT OF PLASMA FOR QUANTITATION OF BLOOD ENDOTOXIN : ITS CLINICAL SIGNIFICANCE IN LIVER DISEASES松本, 宗輔endotoxinchromogenic substrate assayliver cirrhosisperchloric acidtriethylaminePlasma endotoxin was measured in 31 patients with alcoholic liver diseases
and in 90 patients with liver cirrhosis by the chromogenic substrate assay in which plasma
was pretreated by an improved method. Pretreatment of plasma with perchloric acid
yielded a soluble fraction (supernatant) and an insoluble fraction (precipitate) ; the super-
natant was neutralized with 0.18 M sodium hydoxide and the precipitate was solubilized
and neutralized by adding 10% triethylamine. Endotoxin concentrations in these two
fractions were measured by the use of S-2423 or endotoxin-specific Endospecy as a sub-
strate. Irrespective of substrates, a greater part of plasma endotoxin was recovered from
the precipitate in patients with liver cirrhosis. When total endotoxin concentration in
plasma from cirrhotic patients was calculated by the new acid method, it correlated well to
several parameters of liver function including total bilirubin, albumin, prothrombin time
and cholinesterase. Endotoxin concentrations were notably elevated in patients with Child
C cirrhosis. The elevation of plasma endotoxin was prominent in with poor prognosis,
variceal bleeding or advanced hepatoma. Plasma endotoxin detected by this new method
may become a useful clinical parameter to predict the outcome of liver diseases.奈良医学会2009-01-15T02:17:01Z2009-01-15T02:17:01Z1996-04-30ArticleDepartmental Bulletin Paper1386161 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.155-1660469555013450069http://hdl.handle.net/10564/71204695550AN00180974奈良医学雑誌472155166jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/7132017-05-29T06:07:08Zhdl_10564_1498二次性上皮小体機能亢進症における上皮小体摘除術前後の血清ピリジノリン類の経時的検討SERIAL MEASUREMENT OF SERUM PYRIDINIUM CROSSLINKS BEFORE AND AFTER PARATHYROIDECTOMY IN PATIENTS WITH SECONDARY HYPERPARATHYROIDISM影林, 頼明三馬, 省二米田, 龍生大山, 信雄吉田, 克法窪田, 一男丸山, 良夫大園, 誠一郎本宮, 善恢平尾, 佳彦岡島, 英五郎secondary hyperparathyroidismserum pyridinium crosslinkspostoperative sequential changesparathyroidectomybone metabolic markersTo investigate the clinical usefulness of pyridinium crosslinks, pyridinoline
(Pyr)and deoxypyridinoline (Dpyr), novel markers of bone resorption, in evaluation of the
state of renal osteodystrophy (ROD), serum concentrations of the crosslinks together with
other known ROD markers were measured sequentially in patients with secondary hyper-
parathyroidism (2°HPT) before and after parathyroidectomy (PTX).
In six chronic hemodialysis patients with 2°HPT who underwent PTX and autotrans-
plantation of a resected parathyroid gland from January through August 1994, serial
measurement of serum Pyr, Dpyr, HS-PTH, alkaline phosphatase and osteocalcin was
done. Similarly, serial measurement of urinary Pyr, Dpyr and other markers was done in
two surgically-treated patients with primary hyperparathyroidism (1°HPT). The changes
of these markers were evaluated in each patient and between the patients'with 1°HPT and
2°HPT.
Before PTX, marked elevation of ROD markers including Pyr and Dpyr and severe bone
changes indicative of the advanced ROD stage on plain X-ray films were observed in all
patients with 2°HPT. The changes of Pyr after PTX were parallel to those of Dpyr.
However, the reducing speed of Pyr and Dpyr varied among the patients : patients with
lower Pyr and Dpyr levels before PTX showed a slower decrease of the crosslinks. All
patients out of three in whom serial measurement of the markers in the early phase after
PTX was done, alkaline phosphatase and/or osteocalcin showed a transient elevation
without changes of Pyr and Dpyr levels. In pabients, the changes of alkaline phosphatase,
osteocalcin and the crosslinks were parallel from three months after PTX. The similar
changes of the markers including urinary Pyr and Dpyr to in patients with 2°HPT were
observed in two patients with 1°HPT.
The data suggest that the state of high turnover bone in 2°HPT would be improved
associating with a decrease of PTH secretion after PTX, and bone formation might become
dominant in the process of bone remodeling in the early phase after PTX. It is concluded
that serial measurement of serum pyridinium crosslinks before and after PTX would be
useful in evaluation of changes of ROD lesions in patients with 2°HPT.奈良医学会2009-01-15T02:27:31Z2009-01-15T02:27:31Z1996-04-30ArticleDepartmental Bulletin Paper745525 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.167-1730469555013450069http://hdl.handle.net/10564/71304695550AN00180974奈良医学雑誌472167173jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/7142017-05-29T06:06:28Zhdl_10564_1498細菌由来シトシンデアミナーゼ遺伝子と5-フルオロシトシンによる癌に対する遺伝子治療に関する基礎的研究BASIC INVESTIGATIONS OF GENE THERAPY AGAINST CANCER BY USE OF BACTERIAL CYTOSINE DEAMINASE AND 5-FLUOROCYTOSINE増井, 一弘gene therapycytosine deaminase5-fluorocytosinebystander effectcancerThe gene for bacterial cytosine deaminase (CD) which metabolites the
innocuous prodrug 5-fluorocytosine (5-FC) to the highly toxic drug 5-fluorouracil (5-FU)
was transduced via retrovirus into several cell lines : hepatocllular carcinoma(HCC),
squamous cell carcinoma (SCC) and myoblastoma. Transduction of the CD gene did not
affect the growth rate of these cells. However, the cells genetically modifibd to express CD
were sensitive to 5-FC in a dose-dependent manner, and the modified HCC, SCC and
myoblastoma cells exhibited approximately 120-, 130- and 460-fold higher sensitivity to 5
-FC, respectively, compared with each of the corresponding parental cells. Cells expressing
CD were killed with 5-FC at concentrations achievable in sera of patients receiving clinical
doses of 5-FC. Conversely, there were no significant differences in the susceptibility to 5
-FU between the modified cells and their parental cells. The cells expressing CD were able
to induce the killing of their neighboring parental cells in the presence of 5-FC not only
when they were in contact with each other but also when they were not. The killing ability
of cells expressing CD was closely correlated with amounts of 5-FU generated by the cells.
Most importantly, this killing effect was also observed in vivo. Significant antitumor
effects were induced in mice bearing HCC cells composed of the modified and unmodified
cells by an intraperitoneal injection of 5-FC. When genetically modified HCC cells com-
prised only 10% of a tumormass, significant suppression of HCC development was achieved
by administration of subtoxic doses of 5-FC. These results demonstrated the feasibility of
gene therapy using the bacterial CD gene and 5-FC for the treatment of cancers.奈良医学会2009-01-15T02:36:40Z2009-01-15T02:36:40Z1996-04-30ArticleDepartmental Bulletin Paper1596743 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.174-1860469555013450069http://hdl.handle.net/10564/71404695550AN00180974奈良医学雑誌472174186jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/7152017-06-11T23:20:26Zhdl_10564_1498EPINEPHRINE INDUCES 72-kD HEAT SHOCK PROTEIN (HSP72) IN CULTURED HUMAN FIBROBLASTSHatoko, MitsuoTada, HideyukiKuwahara, MasamitsuMuramatsu, TsutomuShirai, Toshihikostress proteinHSP 72epinephrinefibroblastIn order to know the stress response of cells to epinephrine, we examined
the induction of 72-kD protein (HSP 72) in cultured human fibroblasts using an immuno-
fluorescence method. HSP 72 was induced strongly and rapidly after epinephrine treatment
at a final concentration of 2.7×10⁻⁵ M which corresponds to the concentration of clinical
use. When propranolol (1×10⁻⁴ M) was added to a culture medium containing epinephrine,
the onset and peak of HSP 72 induction of fibroblasts were delayed compared to those
observed after epinephrine treatment alone.
These results suggest that epinephrine is actually a potent inducer of HSP 72 and that the
cells are stressed by epinephrine at a concentration of routine use in surgery. Furthermore,
the induction of HSP 72 by epinephrine is considered to be related to its β-adrenergic
actlon.奈良医学会2009-01-15T02:42:54Z2009-01-15T02:42:54Z1996-04-30ArticleDepartmental Bulletin Paper1960879 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.187-1970469555013450069http://hdl.handle.net/10564/71504695550AN00180974奈良医学雑誌472187197engpublisher
oai:ginmu.naramed-u.ac.jp:10564/7162017-05-29T06:06:28Zhdl_10564_1498胃および十二指腸ポリープに対する留置スネアを用いた内視鏡的ポリペクトミーの経験EXPERIENCE OF POLYPECTOMY AGAINST GASTRIC AND DUODENAL POLYPS BY USE OF SNARE LOOPS増井, 一弘栗山, 茂樹松本, 昌美美登路, 昭宮本, 洋二阪本, たけみ松田, 隆昭山本, 浩治城井, 啓山根, 佳子小林, 洋三中谷, 敏也奥, 和美小泉, 雅紀吉川, 正英菊池, 英亮松村, 雅彦福井, 博polypectomysnare loopgastric polypduodenal polypendoscopic therapyRemarkable developments have been made recently in endoscopic ther-
apies, such as endoscopic sphincterotomy, endoscopic injection sclerotherapy and endos-
copic hematostatic procedures. Specifically, endoscopic polypectomy has been widely used
for the resection of polyps in the digestive tract. As endoscopic polypectomy is employed
for the excision of large polyps, the incidence of serious complications such as hemorrhage
and perforation has been increasing. Hemorrhage is the most frequent serious complication
in endoscopic polypectomy. Therefore, several procedures, such as local injection of
hypertonic saline epinephrine, clipping and ligation methods have been devised to prevent
the complication. We report here our experience of endoscopic polypectomy againt gastric
and duodenal polyps by the use of snare loops. This method is easy to apply. We ligated
the bottom of a polyp by a snare loop, and excised with an electrocautery snare. Case 1 had
a relatively large-sized hyperplastic polyp, 30 mm in diameter, in the posterior wall of
gastric antrum. Endoscopic ultrasonography revealed that the polyp had a vessel at its
bottom. Cases 2 and 3 had adenomatous polyps in the duodenum of 10 mm and 70 mm in
diameter, respectively. In all the cases, after ligating the bottom of a polyp by a snare loop,
endoscopic polypectomy was carried out successfully at the proximal peripheral side with
an electric coagulator without any complications. Endoscopic examination one week after
the polypectomy revealed that there was a snare loop in case 1, which was removed by
biopsy forceps without any bleeding, and that there remained no snare loops in cases 2 and
3. Thus it was demonstrated that ligation by a snare loop is a useful method for preventing
hemorrhage in the endoscopic polypectomy of relatively large-sized gatroduodenal polyps.奈良医学会2009-01-15T07:31:09Z2009-01-15T07:31:09Z1996-04-30ArticleDepartmental Bulletin Paper2544053 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.198-2030469555013450069http://hdl.handle.net/10564/71604695550AN00180974奈良医学雑誌472198203jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/7172017-05-29T06:07:10Zhdl_10564_1498腹腔鏡下副腎摘除術 : 術式導入期5例の経験LAPAROSCOPIC ADRENALECTOMY : EXPERIENCE OF FIVE INITIAL CASES三馬, 省二平尾, 佳彦坂, 宗久百瀬, 均吉田, 克法大園, 誠一郎岡島, 英五郎laparoscopic surgeryadrenalectomyminimally invasive surgeryFrom January 1993 to May 1994, 5 patients with unilateral adrenal tumor
underwent laparoscopic adrenalectomy at the Department of Urology, Nara Medical
University. The preoperative diagnoses were primary aldosteronism in 3 cases and nonfun-
ctioning tumor in 2. Three were on the right side and 2 on the left side. The adrenal gland
was removed laparoscopically in 4 patients ; one case underwent open hemostasis and
extirpation because of intraoperative massive arterial bleeding caused by the slipping out
of a hemoclip. In the 4 cases in which laparoscopic adrenalectomy was completed, the mean
operative time was 401 minutes, ranging from 330 to 490 minutes, and estimated bleeding
volume ranged from 25 to 288 ml (mean 131 ml). Operative complications were localized
pulmonary embolism in one patient, localized renal infarction in one and subcutaneous
emphysema in 2, which could be treated conservatively. Laparoscopic adrenalectomy
requires practice and skill. However, it is less invasive, compared to open adrenalectomy.
It is considered that laparoscopic surgery would be highly useful in the field of adrenal
surgery.奈良医学会2009-01-15T07:38:29Z2009-01-15T07:38:29Z1996-04-30ArticleDepartmental Bulletin Paper695009 bytesapplication/pdf奈良医学雑誌 Vol.47 No.2 p.204-2090469555013450069http://hdl.handle.net/10564/71704695550AN00180974奈良医学雑誌472204209jpnpublisher