2024-03-29T15:56:27Zhttp://ginmu.naramed-u.ac.jp/dspace-oai/request
oai:ginmu.naramed-u.ac.jp:10564/5362017-05-29T06:06:54Zhdl_10564_1533表紙、目次、投稿規定、奥付(Vol.50.No.5)表紙目次投稿規定奥付奈良医学会OtherOthersapplication/pdfJournal of Nara Medical Association Vol.50 No.513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/536Journal of Nara Medical Association, 50(5)http://hdl.handle.net/10564/536http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/536/1/000p.%e8%a1%a8%e7%b4%99%e3%80%81%e7%9b%ae%e6%ac%a1%e3%80%81%e6%8a%95%e7%a8%bf%e8%a6%8f%e5%ae%9a%e3%80%81%e5%a5%a5%e4%bb%98%28JNMAVol.50.No.5%29.pdf13450069AA11252383Journal of Nara Medical Association5051999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5372017-05-29T06:06:54Zhdl_10564_15331998年の奈良県における小児急性神経疾患の発生状況A SUBSEQUENT REGIONAL SURVEY IN NARA ON INCIDENCE OF INFANTILE ACUTE NEUROLOGICAL DISORDERS IN 1998西野, 正人吉岡, 章regional surveyinfantile acute neurologic disordersvaccmatlonA regional survey of the incidence of several acute infantile neurological
disorders in 1998 was performed in Nara subsequently to 1997, concerning the incidence of
adverse effects in preventive vaccinations.
The total number (397) of cases reported in 1998 was very similar to that (394) in 1997,
and the numbers of each neurological disease were also close to those in the previous year.
The most frequent disorder in the survey was aseptic meningitis with 254 cases, while the
second was epilepsy with 96 cases. In encephalitis/encephalopathy, 6 out of 12 cases were
of complication of Influenza infection and the others were of unknown origin. Two patients
died, as one case was complicated with influenza A virus infection and another was after
the vaccination of Encephalitis japonica. In bacterial meningitis, 9 cases occurred with a
ratio of 4.0 out of 100,000 children (under 15 years old), and Epilepsy incidence could be
suspected in 144 of 100,000 children in Nara.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.345-35013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/537Journal of Nara Medical Association, 50(5): 345-350http://hdl.handle.net/10564/537http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/537/1/345-350p.1998%e5%b9%b4%e3%81%ae%e5%a5%88%e8%89%af%e7%9c%8c%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e5%b0%8f%e5%85%90%e6%80%a5%e6%80%a7%e7%a5%9e%e7%b5%8c%e7%96%be%e6%82%a3%e3%81%ae%e7%99%ba%e7%94%9f%e7%8a%b6%e6%b3%81.pdf13450069AA11252383Journal of Nara Medical Association5053453501999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5382017-05-29T06:06:31Zhdl_10564_1533ルイス肺癌マウスモデルでのクラリスロマイシンのサイトカイン発現に及ぼす効果EFFECTS OF CLARITHROMYCIN ON THE EXPRESSION OF CYTOKINE MESSENGER RNA IN MICE BEARING LEWIS LUNG CARCINOMA CELLS植田, 勝廣clarithromycinLewis lung carcinomacytokineanimal modelA long-term treatment of clarithromycin (CAM), a 14-membered ring
macrolide antibiotic, was shown to increase the median survival time for patients with
unresectable non small-cell lung cancer. This study was addressed to determine the effects
of CAM treatment on the expression of cytokine mRNA in spleen cells of mice bearing
Lewis lung carcinoma (LLC). In mice which were not inoculated with LLC cells, there was
no difference in the expression profile of cytokine mRNAs between the CAM-treated group
and the non-CAM group. In mice bearing LLC, however, the expressions of mRNAs for IL
-4, IL-12 p 40, and IFN-γ was increased, but that of IL-6 mRNA was decreased in the CAM
-treated group, compared to the non-CAM group. Administration of anticancer agents,
including CDDP and VDS, resulted in the suppresssion of cytokine mRNA expression. The
combination therapy of CAM and these anticancer agents restored the expression level of
mRNAs for IL-2, IL-4, IL-12, and IFN-γ up to the same level as observed in tumor-bearing
mice treated with CAM alone, and also decreased IL-6 mRNA expression. When CAM
administration was initiated 1 week after anticancer therapy, these changes for the expres-
sion of cytokine mRNAs were more marked. These results suggest that CAM stimulates
the well-balanced expansipn of helper T-cell subsets in tumor-bearing hosts recovering
from immunosuppression caused by anticancer chemotherapy. Thus, CAM may be a
promising adjuvant drug to anti-cancer chemotherapy, and treatment with this macrolide
should be initiated after some interval but not immediately after basic cancer therapy.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.351-36513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/538Journal of Nara Medical Association, 50(5): 351-365http://hdl.handle.net/10564/538http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/538/1/351-365p.%e3%83%ab%e3%82%a4%e3%82%b9%e8%82%ba%e7%99%8c%e3%83%9e%e3%82%a6%e3%82%b9%e3%83%a2%e3%83%87%e3%83%ab%e3%81%a7%e3%81%ae%e3%82%af%e3%83%a9%e3%83%aa%e3%82%b9%e3%83%ad%e3%83%9e%e3%82%a4%e3%82%b7%e3%83%b3%e3%81%ae%e3%82%b5%e3%82%a4%e3%83%88%e3%82%ab%e3%82%a4%e3%83%b3%e7%99%ba%e7%8f%be%e3%81%ab%e5%8f%8a%e3%81%bc%e3%81%99%e5%8a%b9%e6%9e%9c.pdf13450069AA11252383Journal of Nara Medical Association5053513651999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5392017-06-11T23:20:26Zhdl_10564_1533N-nitrosobis(2-hydroxypropyl)amine(BHP)によるラット肺と食道発癌に対するbovine lactoferrinの影響EFFECTS OF BOVINE LACTOFERRIN ON LUNG AND ESOPHAGEAL CARCINOGENESIS BY N-NITROSOBIS (2-HYDROXYPROPYL)AMINE (BHP) IN RATS吉田, 順一bovine lactoferrin (bLF)N-nitrosobis (2-hydroxypropyl) amine (BHP)ratslungesophagusEffects of bovine lactoferrin (bLF) on lung and esophageal carcinogenesis
by N-nitrosobis(2-hydroxypropyl)amine (BHP) were studied in rats. Male Wistar rats
received 2000 ppm BHP in drinking water for 12 weeks, followed by 0.5% or 2% bLF for
8 weeks or the same doses of bLF for the entire experimental period of 20 weeks. Lung and
esophageal lesions were histopathologically analyzed. No toxic signs including growth
retardation and decreased amount of food intake of bLF were observed. The diet containing
0.5% bLF given after BHP inhibited lung adenoma development and the diets containing
0.5 or 2% bLF given with BHP for 12 weeks followed by without BHP for 8 weeks reduced
the numbers of alveolar hyperplasias and of lung lesions including alveolar hyperplasia,
squamous metaplasia, adenoma, adenocarcinoma and adenosquamous carcinoma. The
diets containing two doses of bLF did not affect esophagial carcinogenesis. No promoting
effects of bLF on lung and esophagial carcinogenesis by BHP in rats were observed.
These results suggest that bLF is a possible candidate as a chemopreventive agent for
lung carcinogenesis.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.366-37413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/539Journal of Nara Medical Association, 50(5): 366-374http://hdl.handle.net/10564/539http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/539/1/366-374p.N-nitrosobis%282-hydroxypropyl%29amine%28BHP%29%e3%81%ab%e3%82%88%e3%82%8b%e3%83%a9%e3%83%83%e3%83%88%e8%82%ba%e3%81%a8%e9%a3%9f%e9%81%93%e7%99%ba%e7%99%8c%e3%81%ab%e5%af%be%e3%81%99%e3%82%8bbovine_lactoferrin%e3%81%ae%e5%bd%b1%e9%9f%bf.pdf13450069AA11252383Journal of Nara Medical Association5053663741999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5402017-08-23T06:32:17Zhdl_10564_1533N-Nitrosobis(2-oxopropyl)amineによるハムスター膵と肝内胆管癌発生に対するN-(4-hydroxyphenyl)retinamideの影響EFFECTS OF N-(4-HYDROXYPHENYL)RETINAMIDE ON PANCREATIC AND INTRA-HEPATIC BILE DUCT CARCINOGENESIS BY N-NITROSOBIS(2-OXOPROPYL)AMINE IN HAMSTERS笛木, 修hamsterpancreasliverN-(4-hydroxyphenyl) retinamide(4-HPR)chemo-preventlonEffects of N-(4-hydroxyphenyl)retinamide (4-HPR), a synthetic retinoid,
on pancreatic duct and intra-hepatic bile duct carcinogenesis were investigated using a
rapid production of pancreatic duct carcinomas in hamsters and the following results were
obtained.
1. No toxic signs including growth retardation and loss of pancreas and liver weights of
4-HPR were observed.
2. As pancreatic ductal lesions, duct epitherial hyperplasia, atypical hyperplasia and
adenocarcinoma were histologically observed.
3. The diet containing 0.0015% 4-HPR reduced the numbers of atypical hyperplasia,
adenocarcinoma and total ductal lesions.
4. The diet containing 0.01% and 0.04% 4-HPR increased the incidence and number of
intra-hepatic bile duct carcinoma.
These results indicate that 4-HPR possesses diverse actions inhibiting pancreatic duct
carcinogenesis in low doses, and enhancing intra-hepatic bile duct carcinogenesis in high
doses.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.375-38513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/540Journal of Nara Medical Association, 50(5): 375-385http://hdl.handle.net/10564/540http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/540/1/375-385p.N-Nitrosobis%282-oxopropyl%29amine%e3%81%ab%e3%82%88%e3%82%8b%e3%83%8f%e3%83%a0%e3%82%b9%e3%82%bf%e3%83%bc%e8%86%b5%e3%81%a8%e8%82%9d%e5%86%85%e8%83%86%e7%ae%a1%e7%99%8c%e7%99%ba%e7%94%9f%e3%81%ab%e5%af%be%e3%81%99%e3%82%8bN-%284-hydroxyphenyl%29retinamide%e3%81%ae.pdf13450069AA11252383Journal of Nara Medical Association5053753851999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5412017-06-11T23:20:26Zhdl_10564_1533消化器症状を有する糖尿病患者のHelicobacter pylori感染と胃十二指腸病変EFFECTS OF HELICOBACTER PYLORI ON GASTRODUODENAL DISORDERS IN DIABETES MELLITUS西浦, 公章川野, 貴弘後一, 肇小泉, 和昭紀川, 伊敏南, 繁敏小川, 修二法田, 浩一helicobacter pylorigastroduodenal disordersdiabetes mellitusDiabetes mellitus frequently complicates various gastroduodenal disorders.
However, the causality involved has not been discussed thoroughly. On the other hand,
many investigations have shown that Helicobacter pylori (H. pylori) infection induces
various gastroduodenal mucosal lesions. In this paper, we report the relationship of H.
pylori infection and gastroduodenal mucosal lesions in diabetic patients. Diabetic patients
with complaints of abdominal discomfort have higher prevalence of H. pylori infection than
controls. Especially there was a significant difference between two groups in.the prevalence
of H. pylori infection in atrophic gastritis. It is suggested that H. pylori infection relates
to gastroduodenal disorders in diabetic patients with complaints.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.386-38913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/541Journal of Nara Medical Association, 50(5): 386-389http://hdl.handle.net/10564/541http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/541/1/386-389p.%e6%b6%88%e5%8c%96%e5%99%a8%e7%97%87%e7%8a%b6%e3%82%92%e6%9c%89%e3%81%99%e3%82%8b%e7%b3%96%e5%b0%bf%e7%97%85%e6%82%a3%e8%80%85%e3%81%aeHelicobacter_pylori%e6%84%9f%e6%9f%93%e3%81%a8%e8%83%83%e5%8d%81%e4%ba%8c%e6%8c%87%e8%85%b8%e7%97%85%e5%a4%89.pdf13450069AA11252383Journal of Nara Medical Association5053863891999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5422017-08-23T06:35:22Zhdl_10564_1533孤立性胃静脈瘤に対する内視鏡的硬化療法ENDOSCOPIC INJECTION SCLEROTHERAPY FOR SOLITARY GASTRIC VARICES松村, 雅彦solitary gastrlc varlcesendoscopic injection sclerotherapydirect injection methodethanolamine oleate containing IopamidolprognosisThe author designed a direct injection method of endoscopic injection
sclerotherapy (EIS) for solitary gastric varices and here reports its methodology and
efficacy. The subjects studied were 105 patients with solitary gastric varices. Sixty-seven
of them were treated with EIS and 38 were observed without EIS. The sclerosant, 5%
ethanolamine oleate containing Iopamidol, was directly injected to the varices under X-ray
monitoring. The author developed techniques to improve retention of the sclerosant and to
minimize bleeding at the puncture site. Efficacy of EIS could be evaluated 1 to 3 months
later in 61 cases. The gastric varices disappeared by the EIS in 40 of 61 patients (65.6%)
and did not change in only 1 patient. In patients with bleeding varices, rate of hemostasis
was higher and cumulative rates of re-bleeding, bleeding deaths and mortality rate were
lower in patients with EIS than those with conservative treatment. In patients with non-
bleeding F₂ and F₃ varices, cumulative rates of bleeding, bleeding deaths and mortality rate
were also lower in patients with EIS than those with conservative treatment. Multivariate
analysis by the multiple logistic model revealed that high Child grading, loss of EIS and
bleeding on admission were significant factors for poor prognosis indicating bleeding and
death within 1 year. Angiography showed that the varices and feeding vessels disappeared
in almost all cases, but the drainage vessels were left in half the cases after EIS. As
complications, mild shock, pleural effusion and ascites were observed in a few cases. No
other serious complications were observed. The present study suggests that this direct
injection method of EIS is an effective treatment to control and prevent bleeding from
gastric varices.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.390-40113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/542Journal of Nara Medical Association, 50(5): 390-401http://hdl.handle.net/10564/542http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/542/1/390-401p.%e5%ad%a4%e7%ab%8b%e6%80%a7%e8%83%83%e9%9d%99%e8%84%88%e7%98%a4%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e5%86%85%e8%a6%96%e9%8f%a1%e7%9a%84%e7%a1%ac%e5%8c%96%e7%99%82%e6%b3%95.pdf13450069AA11252383Journal of Nara Medical Association5053904011999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5432017-08-23T06:47:53Zhdl_10564_1533非ステロイド性抗炎症剤による胃粘膜病変に関する臨床病理学的ならびに実験的研究CLINICOPATHOLOGICAL AND EXPERIMENTAL STUDY ON GASTRIC MUCOSAL LESIONS INDUCED BY NONSTEROIDAL ANTIINFLAMMATORY DRUGS山尾, 純一nonsteroidal antiinflammatory drugsgastric mucosal lesiongastrlc ulcerclinical studyexperimental studyThe influence of nonsteroidal antiinflammatory drugs (NSAIDs) on the
development of gastric mucosal lesions (GMLs) was investigated clinicopathologically in
patients with rheumatoid arthritis (RA) and experimentally in rats treated with NSAIDs.
Two hundred and seventy-three patients with RA including 248 patients under NSAIDs
therapy were employed in this clinical study. GMLs were classified into two categories,
gastritis and/or gastric erosion (GGE) and gastric ulcer (GU). Of 273 patients with RA,
GMLs were found in 146 patients, consisting of 90 patients with GGE, 32 patients with GU
and 24 patients with both GGE and GU. Frequencies of GMLs were 58% (143/248) in RA
patients under NSAIDs therapy and 12% (3/25) in those without NSAIDs, indicating a
close association between development of GMLs and treatment with NSAIDs. Interesting-
ly, patients under rectal NSAIDs therapy also developed GMLs at an almost the same
frequency as those under oral NSAIDs therapy. The development of GMLs was confirmed
experimentally in rats given sodium diclofenate intrarectally, suggesting that rectal admin-
istration of NSAIDs is not safe enough to prevent GMLs induced by NSAIDs. On the other
hand, the use of NSAIDs prodrugs may reduce the incidence of GMLs. Acidity in gastric
juice was increased in patients with GMLs. In NSAIDs-treated rats, H₂ receptor antago-
nists (H₂-RAs) and proton pump inhibitor (PPI) were both effective in preventing GMLs.
In the present clinical observation, PPI was superior to H₂-RAs in healing GU in the
patients treated with NSAIDs. The gastric mucosal blood flow measured by laser Doppler
flow meter was decreased in RA patients with GU. Multi-variate analysis using Cox's
hazard model clarified that healing of GU induced by NSAIDs was influenced by Stein-
brocker's class, by location and size of GU, and by medication for GU.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.402-41713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/543Journal of Nara Medical Association, 50(5): 402-417http://hdl.handle.net/10564/543http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/543/1/402-417p.%e9%9d%9e%e3%82%b9%e3%83%86%e3%83%ad%e3%82%a4%e3%83%89%e6%80%a7%e6%8a%97%e7%82%8e%e7%97%87%e5%89%a4%e3%81%ab%e3%82%88%e3%82%8b%e8%83%83%e7%b2%98%e8%86%9c%e7%97%85%e5%a4%89%e3%81%ab%e9%96%a2%e3%81%99%e3%82%8b%e8%87%a8%e5%ba%8a%e7%97%85%e7%90%86%e5%ad%a6%e7%9a%84%e3%81%aa%e3%82%89%e3%81%b3%e3%81%ab%e5%ae%9f%e9%a8%93%e7%9a%84%e7%a0%94%e7%a9%b6.pdf13450069AA11252383Journal of Nara Medical Association5054024171999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5442017-05-29T06:06:31Zhdl_10564_1533日本人中高年女性におけるエストロゲン受容体遺伝子多型と骨代謝指標ならびに腰椎骨密度との関連性RELATIONSHIP BETWEEN ESTROGEN RECEPTOR GANE POLYMORPHISMS AND BONE MINERAL DENSITY OR BONE METABOLIC MARKERS : STUDIES IN JAPANESE MIDDLE-AND HIGHER-AGED WOMEN大門, 位守estrogen receptor geneDNA polymorphismbone mineral densitybone metabolic markersThe estrogen receptor (ER) gene polymorphisms of PvuⅡ and XbaⅠ
restriction were examined in parallel with bone mineral density of the lumbar vertebrae
(BMD) and bone metabolic markers, such as serum bone Gla protein (BGP), serum bone
alkaline phosphatase (B-ALP) and urinary hydroxyproline (Hyp), in 178 healthy Japanese
women, 30 of whom were premenopausal and 148 postmenopausal. The allele was defined
as capital P or X, when the ER gene was not digested with Pvu Ⅱ or Xba Ⅰ ; otherwise, it
was defined as small letter p or x. The distribution of the Pvu Ⅱ and Xba Ⅰ restriction
fragment length polymorphism (RFLP) was as follows:PP, 32 (16.9%):Pp, 96 (50.8%);
pp. 61 (32.3%) and XX, 5 (2.6%);Xx, 74 (39.2%);and xx, 110 (58.2%);respectively.
The allele frequencies were 42.3% for P, 57.7% for p, 22.2% for X and 77.8% for x. In
PX haplotype distribution, 5 (2.6%), 19 (10.1%), 8 (4.2%), 51 (27.0%), 45 (23.8%), 4
(2.1%) and 57 (30.2%) of the subjects had PPXX, PPXx, PPxx, PpXx, Ppxx, ppXx and
ppxx types, respectively. Neither PpXX nor ppXX haplotype was found in the study
subjects. Pvu Ⅱ genotypes had no correlation with either BMD or biochemical markers for
the bone metabolism. Although the subjects with heterozygous Xx genotype had higher
BMD than those with homozygous XX or xx, Xba Ⅰ genotypes did not have any statisti-
cally significant correlation with the bone metabolic markers. These results suggest that
ER gene polymorphisms of Pvu Ⅱ and Xba Ⅰ restriction may not have any effect on either
osteogenetic or osteoclastic steps of the bone metabolism, at least in Japanese middle-and
higher-aged women.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.418-43013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/544Journal of Nara Medical Association, 50(5): 418-430http://hdl.handle.net/10564/544http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/544/1/418-430p.%e6%97%a5%e6%9c%ac%e4%ba%ba%e4%b8%ad%e9%ab%98%e5%b9%b4%e5%a5%b3%e6%80%a7%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e3%82%a8%e3%82%b9%e3%83%88%e3%83%ad%e3%82%b2%e3%83%b3%e5%8f%97%e5%ae%b9%e4%bd%93%e9%81%ba%e4%bc%9d%e5%ad%90%e5%a4%9a%e5%9e%8b%e3%81%a8%e9%aa%a8%e4%bb%a3%e8%ac%9d%e6%8c%87%e6%a8%99%e3%81%aa%e3%82%89%e3%81%b3%e3%81%ab%e8%85%b0%e6%a4%8e%e9%aa%a8%e5%af%86%e5%ba%a6%e3%81%a8%e3%81%ae%e9%96%a2%e9%80%a3%e6%80%a7.pdf13450069AA11252383Journal of Nara Medical Association5054184301999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5452017-09-06T16:30:06Zhdl_10564_1533RESULTS OF EATON AND LITTLER'S LIGAMENT RECONSTRUCTION FOR INSTABILITY OF THE FIRST CARPOMETACARPAL JOINTMaeda, YujiInada, YujiNosaka, YoshimasaMitsuno, HiroyaKawanishi, KoichiMiyamoto, SeijiTamai, SusumuEaton and Littler's ligament reconstructionfirst carpometacarpal jointThis study presents the cases of Eaton and Littler's ligament reconstruction
for the treatment of instability of lst CM joint resulting from early stage osteoarthritis
(Group OA), trauma (Group T), and a part of generalized joint laxity (Group GJL) in 21
joints of 20 cases. Omitting six cases with less than one year follow-up, 15 joints in 14 cases
were analyzed. Clinically, hypermobility pain was improved in all joints. However, eight
out of 14 patients felt their joints stretched, but still had the normal range of motion. Grip
power and pinch power was significantly improved (P<0.01, P<0.05). Comparing each
group, only Group T revealed a significant difference between preoperative and postoper-
ative grip power (P<0.01). In increase of grip power, Group T were more significantly
improved than Group OA (P<0.01) and Group GJL (P<0.05). Radiographically, postoper-
ative stages of 4 joints in 4 cases out of 8 cases which felt stretched progressed from their
preoperative stages. We assumed that the newly reconstructed ligament may be strong
enough to maintain the stability of 1st CM joint and ligament reconstruction is most
effective in treating post-traumatic instability.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.431-44113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/545Journal of Nara Medical Association, 50(5): 431-441http://hdl.handle.net/10564/545http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/545/3/p.431-441.pdf13450069AA11252383Journal of Nara Medical Association5054314411999-10-31engpublisher
oai:ginmu.naramed-u.ac.jp:10564/5462017-05-29T06:06:31Zhdl_10564_153338口径低速弾による銃創の1例A CASE OF GUNSHOT WOUND BY 0.38 INCH LOW-VELOCITY BULLET小延, 俊文川西, 弘一畑, 倫明稲田, 有史今西, 正巳村尾, 佳則宮本, 誠司上嶋, 昌和植村, 天受平尾, 佳彦penetratlng injurygunshot woundlow-velocity bulletA case of gunshot wound by 0.38 inch low-velocity bullet is reported. A 41
-year-old man was admitted to our hospital due to gunshot wounds. Three open wounds
were recognized in the hip, right femoral region, and right lower leg on arrival. Also
subcutaneous hematoma was found in the right femoral region. X-ray films on admission
revealed a bullet in the right femoral region and injury of the femur bone. Pelvic CT scan
revealed hematoma in the bladder and bullet fragments; however, no more associated
injury was detected. Then, we diagnosed as non-penetrating wound through pelvic cavity
and penetrating wound, entered from femoral region through lower leg. We removed the
bullet and made debridement. The patient was discharged from our hospital on the 12th
postoperative day and his postoperative course was uneventful. Since the bullet in this case
was a 0.38 inch low-velocity bullet, it seemed that the degree of injury was not severe.
Gunshot wound victims have been rarely seen in Japan, however, the system such as
Advanced Trauma Life Support (ALTS) in the U.S.A should be established in Japan.
Emergency physicians should know ballistics and gunshot wound management.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.442-44613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/546Journal of Nara Medical Association, 50(5): 442-446http://hdl.handle.net/10564/546http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/546/1/442-446p.38%e5%8f%a3%e5%be%84%e4%bd%8e%e9%80%9f%e5%bc%be%e3%81%ab%e3%82%88%e3%82%8b%e9%8a%83%e5%89%b5%e3%81%ae1%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5054424461999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5472017-05-29T06:06:55Zhdl_10564_1533特発性間質性肺炎の治療中に肺結核症を併発した高齢者の1例A CASE OF ELDERLY PATIENT WITH PULMONARY TUBERCULOSIS UNDER TREATMENT OF IDIOPATHIC INTERSTMAL PNEUMONIA佐々木, 理恵山野, 繁京田, 有輔西本, 和央中嶋, 民夫橋本, 俊雄土肥, 和紘藤井, 謙裕elderly patlentidiopathic interstitial pneumomapulmonary tuberculosissteroid therapyA case of idiopathic interstitial pneumonia with pulmonary tuberculosis is
reported. The patient was a 70-year-old man. On March 14, 1997, he visited Saiseikai Gose
Hospital because of dyspnea on effort, which started in early March. He was diagnosed
with acute interstitial pneumonia and admitted to the hospital the same day. After
admission, respiratory failure worsened, but after steroid pulse therapy, respiratory func-
tion improved. Since April 20, the patient complained of cough and fever again, and
tubercle bacilli, Gaffky Ⅶ, were found in his sputum. He was admitted to our hospital for
treatment of pulmonary tuberculosis. The Gaffky score decreased with therapy, but liver
dysfunction developed, so treatment was interrupted. Early in September, respiratory
failure worsened again. Gaffky score was 0, but chest X-ray findings led to a diagnosis of
recrudescence of idiopathic interstitial pneumonia. After steroid pulse therapy, the patient'
s repiratory function improved again. Subsequently, we reduced the steroid dosage gradu-
ally. He was dischanged on May 3, receiving predonisolone 10 mg/day.
This case suggests that in elderly patients under steroid therapy Mycobacterium tubercu-
losis infection should be considered even in the absence of a history of tuberculosis.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.447-45213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/547Journal of Nara Medical Association, 50(5): 447-452http://hdl.handle.net/10564/547http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/547/1/447-452p.%e7%89%b9%e7%99%ba%e6%80%a7%e9%96%93%e8%b3%aa%e6%80%a7%e8%82%ba%e7%82%8e%e3%81%ae%e6%b2%bb%e7%99%82%e4%b8%ad%e3%81%ab%e8%82%ba%e7%b5%90%e6%a0%b8%e7%97%87%e3%82%92%e4%bd%b5%e7%99%ba%e3%81%97%e3%81%9f%e9%ab%98%e9%bd%a2%e8%80%85%e3%81%ae1%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5054474521999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5482017-05-29T06:06:31Zhdl_10564_1533両側肺動脈主幹部血栓塞栓症に対して内科治療が有効であった1例A CASE OF PULMONARY THROMBOEMBOLISM IN THE BILATERAL MAIN PULMONARY ARTERIES TREATED BY THROMBOLYSIS木田, 順富山野, 繁川本, 篤彦中谷, 秀隆中嶋, 民夫橋本, 俊雄土肥, 和紘藤本, 眞一酢谷, 俊夫pulmonary thromboembolismthrombolytic therapydeep vein thrombosisA 59-year old man was admitted because of a sudden onset of dyspnea and
loss of consciousness. A chest radiograph showed increased lung field tranlucency and
enlargement of the pulmonary artery in the hilar region. Enhanced computed tomography
revealed large, obstructing thromboemboli in the bilateral main pulmonary arteries.
Thrombi had also formed in a deep vein of the left leg. After injection of urokinase and
heparin at an early stage, the thromboemboli in the pulmonary arteries and deep vein
disappeared. Pulmonary thromboemboli in the bilateral main pulmonary arteries is rare
and has a high mortality rate. It is suggested that early diagnosis and thrombolytic therapy
could reduce the associated mortality rate.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.453-45813450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/548Journal of Nara Medical Association, 50(5): 453-458http://hdl.handle.net/10564/548http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/548/1/453-458p.%e4%b8%a1%e5%81%b4%e8%82%ba%e5%8b%95%e8%84%88%e4%b8%bb%e5%b9%b9%e9%83%a8%e8%a1%80%e6%a0%93%e5%a1%9e%e6%a0%93%e7%97%87%e3%81%ab%e5%af%be%e3%81%97%e3%81%a6%e5%86%85%e7%a7%91%e6%b2%bb%e7%99%82%e3%81%8c%e6%9c%89%e5%8a%b9%e3%81%a7%e3%81%82%e3%81%a3%e3%81%9f1%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5054534581999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5492017-09-06T04:44:03Zhdl_10564_1533A CASE OF RUPTURED MITRAL VALVE ANEURYSM DUE TO INFECTIVE ENDOCARDITISMizuno, ReikoFujimoto, ShinichiKawata, HiroyukiSakaguchi, HidehitoTaniguchi, ShigekiHashimoto, ToshioDohi, Kazuhiroechocardiographyinfective endocarditismitral valve aneurysm58-year-old woman with aortic regurgitation was admitted to our hospi-
tal because of high grade fever. She had infective endocarditis and an aneurysm of the
anterior mitral leaflet. Doppler echocardiography indicated a ruptured mitral valve
aneurysm. Aortic regurgitant flow along the anterior mitral leaflet was suspected to have
contributed to mitral valve endocarditis, aneurysm formation and rupture. She was initially
treated with high-dose intravenous penicillin, but congestive heart failure worsened. Mitral
valve replacement was then successfully performed.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.459-46313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/549Journal of Nara Medical Association, 50(5): 459-463http://hdl.handle.net/10564/549http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/549/5/459-463p.A_CASE_OF_RUPTURED_MITRAL_VALVE_ANEURYSM_DUE_TO_INFECTIVE_ENDOCARDITIS.pdf13450069AA11252383Journal of Nara Medical Association5054594631999-10-31engpublisher
oai:ginmu.naramed-u.ac.jp:10564/5502017-05-29T06:06:31Zhdl_10564_1533高脂血症を伴った重症急性膵炎の一救命例A CASE OF SEVERE ACUTE PANCREATITIS WITH HYPERLIPIDEMIA野阪, 善雅小延, 俊文村尾, 佳則増井, 一弘畑, 倫明横田, 義子稲田, 有史今西, 正巳宮本, 誠司打田, 日出夫中野, 博重前田, 裕仁西尾, 健治severe acute pancreatltlshyperlipidemianecrosectomyproteinase inhibitorarterial infusionA case of severe acute pancreatitis with hyperlipidemia is reported. A 31
-year-old man was admitted to our hospital due to acute pancreatltls. The enhanced
abdominal CT demonstrated diffuse enlargement of the pancreas with peripancreatic
inflammatory changes and fluid collection. Laboratory da,ta showed elevation of Amylase,
Triglyceride, Lactic dehydrogenase and Blood sugar. Thus, we diagnosed severe acute
pancreatitis with hyperlipidemia and started arterial infusion of proteinase inhibitor. On
the 33rd hospital day, we performed necrosectomy and closed wide pancreatic drainage
because of infectious signs. Postoperatively, the drains were irrigated with saline solution
on a daily basis and we continued arterial infusion of proteinase inhibitor. Hewever, severe
pancreatitis was improved, Triglyceride was elevated. Very Low Density Lipoprotein was
362 mg/dl and Chylomicron was 532 mg/dl. Then, we diagnosed type V hyperlipidemia.
However, acute pancreatitis with hyperlipidemia is not common and the relation between
acute pancreatitis and hyperlipidemia is controversial ; we considered that the control of
hyperlipidemia is important for preventing pancreatitis.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.464-46813450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/550Journal of Nara Medical Association, 50(5): 464-468http://hdl.handle.net/10564/550http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/550/1/464-468p.%e9%ab%98%e8%84%82%e8%a1%80%e7%97%87%e3%82%92%e4%bc%b4%e3%81%a3%e3%81%9f%e9%87%8d%e7%97%87%e6%80%a5%e6%80%a7%e8%86%b5%e7%82%8e%e3%81%ae%e4%b8%80%e6%95%91%e5%91%bd%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5054644681999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5512017-06-11T23:20:26Zhdl_10564_1533逆行性血管柄遠位手掌島状皮弁を利用した手指heat press injuryの1治療例REVERSE VASCULAR PEDICLE PALMAR ISLAND FLAP TRANSFER FOR THE TREATMENT OF HEAT PRESS INJURY IN THE HAND : A CASE REPORT前田, 裕仁稲田, 有史野阪, 善雅三野, 浩也川西, 弘一宮本, 誠司玉井, 進heat press injuryreverse vascular pedicle palmar island flapray amputationA 50-year-old woman experienced severe heat press injuries on the right
middle and ring fingers. A reverse vascular pedicle palmar island flap was elevated from
the mid-palmar lesion of the ring finger, of which resection was planned as a ray amputa-
tion. The middle finger was amputated at the level of the mid-proximal phalanx, and then
a flap was used to cover the major defect of the exposed bone. In addition, a 2 cm callotasis
was performed using the Orthofix mini-100 device at the level of the proximal phalanx of
the middle finger. Nine months later, she was able to work without any limitations and
could hold chopsticks using the reconstructed finger.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.469-47213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/551Journal of Nara Medical Association, 50(5): 469-472http://hdl.handle.net/10564/551http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/551/1/469-472p.%e9%80%86%e8%a1%8c%e6%80%a7%e8%a1%80%e7%ae%a1%e6%9f%84%e9%81%a0%e4%bd%8d%e6%89%8b%e6%8e%8c%e5%b3%b6%e7%8a%b6%e7%9a%ae%e5%bc%81%e3%82%92%e5%88%a9%e7%94%a8%e3%81%97%e3%81%9f%e6%89%8b%e6%8c%87heat_press_injury%e3%81%ae1%e6%b2%bb%e7%99%82%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5054694721999-10-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5522017-06-11T23:20:26Zhdl_10564_1533PRIMARY LIGAMENT RECONSTRUCTION FOR THE TREATMENT OF ACUTE TRAUMATIC DISLOCATION OF THE 1ST CARPOMETACARPAL JOINT : IS IT APPROPRIATE ?Nosaka, YoshimasaInada, YujiMaeda, YujiMitsuno, HiroyaKawanishi, KoichiMiyamoto, SeijiTamai, Susumuprimary ligament reconstructionfirst carpometacarpal jointA case is reported of acute traumatic dislocation to the lst carpometacarpal
joint of the left thumb, treated by ligament reconstruction as first choice.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.50 No.5 p.473-47713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/552Journal of Nara Medical Association, 50(5): 473-477http://hdl.handle.net/10564/552http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/552/1/473-477p.PRIMARY_LIGAMENT_RECONSTRUCTION_FOR_THE_TREATMENT_OF_ACUTE_TRAUMATIC_DISLOCATION.pdf13450069AA11252383Journal of Nara Medical Association5054734771999-10-31engpublisher