2024-03-29T13:36:39Zhttp://ginmu.naramed-u.ac.jp/dspace-oai/request
oai:ginmu.naramed-u.ac.jp:10564/5582017-06-11T23:20:26Zhdl_10564_1535表紙、目次、総目次、投稿規定詳細、奥付(Vol.50 No.6)表紙目次総目次投稿規定詳細奥付奈良医学会2008-11-10T06:29:00Z2008-11-10T06:29:00Z1999-12-31OtherOthers4234609 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.613450069http://hdl.handle.net/10564/55813450069AA11252383Journal of Nara Medical Association506jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5592017-05-29T06:06:31Zhdl_10564_1535肺気腫患者のエネルギー代謝と体成分・呼吸筋力・血清サイトカインとの関連性に関する研究STUDY ON RELATION OF BODY COMPOSITION, RESPIRATORY MUSCLE STRENGTH, AND SERUM CYTOKINES TO ENERGY METABOLISM IN PULMONARY EMPHYSEMA生野, 雅史pulmonary emphysemamalnutritionbody composltlonserum cytokineresting energy expenditure (REE)Increased resting energy expenditure (REE) in underweight patients with
pulmonary emphysema has been previously reported. However, the determinants of REE
have not been clearly demonstrated. The purpose of this study was to investigate the
relations of pulmonary function, respiratory muscle strength (PⅠmax, PEmax), body compo-
sition (FM/IBW, FFM/IBW), and serum cytokines (tumor necrosis factor α (TNF-α),
soluble tumor necrosis receptor type Ⅰ, Ⅱ (sTNF-R Ⅰ, Ⅱ)) to REE in 37 male clinically
stable outpatients with pulmonary emphysema (age : 69.0±6.5, % IBW : 84.7±15.2,
FEV1.0 : 1.26±0.57). Also, I compared them with those in 17 age-and sex-matched healthy
controls (age : 70.0±6.9,% IBW : 98.9±16.3), malnourished patients (% IBW<90 ; 75.2±
8.8, N=22, group A), and normonourished patients (% IBW≧90 ; 99.4±8.8, N=15, group
B). REE was expressed as percentage predicted (% REE), REE/FFM and VO2/FFM.
FFM/IBW, FM/IBW, P1max, PEmax were significantly lower and % REE, REE/FFM, VO2
/FFM, all cytokines were significantly higher in group A than group B and controls. By
stepwise regression analysis, variables significantly contributing to % REE were FFM/
IBW, TLC, and FEV1.0 in group A. These data may suggest that increase in REE in
underweight patients with pulmonary emphysema is associated with a decrease in FFM
which is accompanied by decrease in respiratory muscle strength, airway obstruction, and
hyperinflation.奈良医学会2008-11-10T06:33:20Z2008-11-10T06:33:20Z1999-12-31ArticleDepartmental Bulletin Paper2219101 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.479-49613450069http://hdl.handle.net/10564/55913450069AA11252383Journal of Nara Medical Association506479496jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5602017-05-29T06:06:55Zhdl_10564_1535胸膜下病変の質的診断に対する超音波パワードプラ法の臨床応用CLINICAL APPLICATION OF POWER DOPPLER SONOGRAPHY FOR THE QUALITATIVE DIAGNOSIS OF SUBPLEURAL LESIONS浜崎, 直樹ultrasonographycolor Doppler imagingpower Doppler imagingsubpleural lesionThe purpose of this investigation was to assess the usefulness of power
Doppler sonography (PDS) for the qualitative diagnosis of subpleural lesions in comparison
with color Doppler sonography (CDS). Sixty-seven lesions (36 pneumonias, 8 pulmonary
abscesses, 17 primary lung cancers, 6 metastatic lung cancers) were examined. Color flow
patterns of subpleural lesions depicted by color flow imaging were classified into seven
groups. PDS was better than CDS in the ability of showing color flow. Color flow patterns
of pneumonias obtained in PDS differed significantly from patterns of lung cancers. Color
flow patterns of the benign groups obtained in PDS differed significantly from patterns of
the malignant group. These findings illustrated the usefulness of PDS as a means of
diagnosing benign and malignant subpleural lesions.奈良医学会2008-11-10T06:38:04Z2008-11-10T06:38:04Z1999-12-31ArticleDepartmental Bulletin Paper18914879 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.497-50813450069http://hdl.handle.net/10564/56013450069AA11252383Journal of Nara Medical Association506497508jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5612017-05-29T06:06:31Zhdl_10564_1535砂ねずみ海馬スライスにおける低酸素負荷に対するアシドーシスの影響EFFECTS OF ACIDOSIS ON THE POSTHYPOXIC RECOVERY OF SYNAPTIC TRANSMISSION IN GERBIL HIPPOCAMPAL SLICES鎌田, 喜敬acidosishypoxiagerbilneuroprotectlonhippocampal sliceWe investigated the effect of acidosis on hypoxic neuronal damage using
gerbil hippocampal slices. Acidosis could delay the onset of harmful hypoxic depolariza-
tion, but the synaptic recovery after reoxygenation was attenuated when acidosis was
sustained. Conversely, synaptic recovery was potentiated when acidosis was restored to the
physiological milieu during the period of reoxygenation. These results suggest that acidosis
exerts a protective effect on hypoxic neuronal damage only when rapid appreciable pH
recovery is achieved during reoxygenation.奈良医学会2008-11-10T06:42:05Z2008-11-10T06:42:05Z1999-12-31ArticleDepartmental Bulletin Paper739088 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.509-51413450069http://hdl.handle.net/10564/56113450069AA11252383Journal of Nara Medical Association506509514jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5622017-06-11T23:20:26Zhdl_10564_1535PLASMA P-SELECTIN IN CHILDREN WITH HEMOLYTIC UREMIC SYN-DROME CAUSED BY ESCHERICHIA COLI O157 : H7Kamitsuji, HidekazuNonami, KazumaIshikawa, NaokoMurakami, TomohikoNakayama, AkifumiUmeki, YayoiNakajima, Mitsuruhemolytic uremic syndromeverotoxinP-selectinMicrovascular thrombosis in the kidney plays an important role in the
pathogenesis of hemolytic uremic syndrome (HUS). To evaluate the pathophysiological
significance of the plasma levels of P-selectin, which is releared from activated or damaged
endthelial cells, we measured the plasma concentrations of this protein in children with
HUS associated with verotoxin-producing Escherichia coli (VTEC). In the acute phase of
HUS, plasma levels of P-selectin were significantly higher than those in non-HUS or
healthy controls, and returned to normal range in the recovery phase. The elevated levels
of plasma P-selectin were found to correlate with an increase in soluble thrombomodulin
and thrombin antithrombin Ⅲ complex, implying an association between platelet activation,
endothelial cell injury and activation of the coagulation cascade. However, there was no
definite correlation between P-selectin levels and platelet counts or serum creatinine levels.
From these findings, we concluded that the elevation of elevated circulating P-selectin
levels in HUS associated with VTEC infection is related to endothelial cell injury and
platelet activation as a primary event, and its measurement may be helpful for an early
diagnosis of this disease.奈良医学会2008-11-10T06:49:56Z2008-11-10T06:49:56Z1999-12-31ArticleDepartmental Bulletin Paper729724 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.515-52313450069http://hdl.handle.net/10564/56213450069AA11252383Journal of Nara Medical Association506515523engpublisher
oai:ginmu.naramed-u.ac.jp:10564/5632017-05-29T06:06:31Zhdl_10564_1535第1仙椎近傍における神経・血管解剖 : Iliosacral screw 刺入における合併症予防をめざしてJAPANESE MORPHOLOGIC CONSIDERATIONS FOR ILIOSACRAL SCREW PLACEMENT前田, 裕仁稲田, 有史川西, 弘一三野, 浩也相澤, 茂幸野阪, 善雅福島, 英賢宮本, 誠司iliosacral screwanatomyS1 pediclecomplicationpelvic fractureIliosacral screw placement has recently become a popular method of treat-
ment for pelvic disruption fractures. It provides stable fixation that is biomechanically
equal or superior to other techniques and requires less invasive surgery. However, recently,
some iatrogenic complications have been reported, including radiculopathy of lumbo-sacral
nerve, and arterial injury derived from miscannulation of screws in fluoroscopic image-
guided procedures. The purpose of this stydy was to investigate the proximity of neurovas-
cular structures in Japanese people to the first sacral (S1) body in which screws will be
inserted. Twenty- five human Japanese cadavers were investigated. The distance to each
structure was measured from the mid-point of the promontorium in the surface parallel to
the S1 body. Latitudinal measurement was performed: X longitudinal: Y. The mean
distances were as follows : 1.) L3: X, 43.7±9.0 mm, Y, 19.3±9.5 mm ; 2.) L4; X, 42.6±
12.1 mm, Y, 20.9±10.0 mm ; 3.) L5: X, 33.9±6.4 mm, Y, 24.5±9.0 mm ; 4.) internal iliac
vein : X, 28.5±8.5 mm, Y, 7.4±7.5 mm ; 5.) internal iliac artery ; X, 28.7±10.4 m, Y, 5.5
mm±10.0 mm. These results suggest that if screws penetrate the sacral body, the L 5 nerve
will be severely injured. Vascular structures will escape screw-related injury.奈良医学会2008-11-10T06:54:43Z2008-11-10T06:54:43Z1999-12-31ArticleDepartmental Bulletin Paper1516971 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.524-53013450069http://hdl.handle.net/10564/56313450069AA11252383Journal of Nara Medical Association506524530jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5642017-05-29T06:06:31Zhdl_10564_1535梗塞責任血管における再灌流後の冠微小循環障害の検討 : 冠予備能と冠コンダクタンスによる評価STUDIES ON IMPAIRMENT OF CORONARY MICROCIRCULATION IN THE INFARCT RELATED ARTERY AFTER REPERFUSION THERAPY : RELATIONSHIP BETWEEN CORONARY FLOW RESERVE AND CORONARY CONDUCTANCE林, 照剛myocardial infarctioncoronary microcirculationcoronary flow reservecoronary conductancePrevious studies have utilized coronary flow reserve (CFR) to evaluate
coronary microcirculation. However, the limitations of CFR in the assessment of coronary
microcirculation have been well described. Recently, coronary conductance can be mea-
sured in patients with ischemic heart disease. Measurements of coronary conductance are
obtained from the slope of the instantaneous end-diastolic relation between coronary flow
velocity and atrtic pressure using spectral analysis of the intracoronary Doppler signal. It
has been reported that coronary conductance may be able to evaluate coronary microcir-
culation less affected by hemodynamic conditions than CFR. The purpose of this study was
to investigate whether evaluation of coronarry microcirculation in the infarct related artery
by coronary conductance is more useful than CFR. We studied 15 anterior myocardial
infarction patients with single vessel disease. Follow-up coronary angiography was
performed 3 months after successful direct angioplasty, where no restenosis occurred. In
the acute phase and chronic phase, we assessed the phasic coronary flow velochity pattern
of the infarct related artery (IRA) and the non-infarcted artery (NIA) using a 0.014-inch
Doppler guidewire (FloWire, Cardiometrics, Inc.) at rest and during hyperemia induced by
intravenous administration of adenosine triphosphate disodium (150 μg/kg/min). CFR was
obtained from the hyperemic/baseline flow velocity ratio. We also calculated coronary
conductance at rest and during hyperemia.
As a result, the CFR values were found to be lower in the IRA than the NIA in the acute
phase. However, in the chronic phase there were no significant differences between the
CFR values obtained in the IRA and in the NIA. The recovery of CFR in the IRA was
sufficient 3 months after successful direct angioplasty. There were no significant differ-
ences between coronary conductance at rest in the IRA and in the NIA, although coronary
conductance during hyperemia was lower in the IRA than the NIA both in the acte and
chronic phases. The recovery of coronary conductance in the IRA was insufficient 3 months
after successful direct angioplasty. These results have been taken to suggest that impair-
ment of coronary microcirculation in the IRA remains for a period of 3 months after
successful direct angioplasty.奈良医学会2008-11-10T07:10:28Z2008-11-10T07:10:28Z1999-12-31ArticleDepartmental Bulletin Paper1431394 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.531-54213450069http://hdl.handle.net/10564/56413450069AA11252383Journal of Nara Medical Association506531542jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5652017-05-29T06:06:55Zhdl_10564_1535培養骨髄細胞含浸人工真皮移植による創傷治癒促進効果についての検討WOUND HEALING EFFICACY OF RAT STROMAL CELLS COMBINED WITH SPONGY COLLAGEN MATRIX (PELNAC)三野, 浩也川西, 弘一稲田, 有史宮本, 誠司吉川, 隆章市島, 國雄artificial dermisbone marrow cellskin defectcollagen spongewound healing[Purpose] Recently, reconstruction of skin defects using artificial dermis
composed of an outer layer of silicone and an inner sponge layer of collagen has been
developed and is performed clinically. When the artificial dermis is grafted onto a total
skin defect, the inner sponge layer spontaneously converts into dermis-like connective
tissue. However, 2 or 3 weeks after the application of the artificial dermis, a secondary split
-thickness skin graft on the dermis-like tissue is required for skin resurfacing. Until the
secondary skin graft, problems of wound infection or tissue fluid leakage persist.
In this study, the authors investigated the effect of cultured bone marrow cells on the
synthesis of dermis-like tissue using artificial dermis in rats.
[Methods] Two rats were sacrificed to harvest bone marrow cells from the femurs, and
the cells were cultured for 10 days. Full thickness skin defects (3 cm×4 cm) were made on
the backs of 20 male Fisher rats, then the rats were divided into 5 groups. The artificial
dermis containing 10^4(10^5, 5×10^5, 10^6)/ml bone marrow cells were grafted on the skin
defects of rats in Group 1(2, 3, 4). In Group 5, artificial dermis only was grafted. After 10
days, the grafted artificial dermis was harvested, and histological examination was perfor-
med. In each group, mean thickness of dermis-like tissue, which was infiltrated by
fibroblasts and capillaries, was measured.
[Result] The dermis-like tissue was significantly thicker in Groups 1~4 than in Group
5, and was significantly thickest in Group 2.
[Conclusion] Histologically, topical application of bone marrow cells accelerates prolif-
eration of fibroblasts and capillaries in artificial dermis. Therefore, this study suggests the
usefulness of bone marrow cells combined with artificial dermis for wound healing.奈良医学会2008-11-10T07:28:38Z2008-11-10T07:28:38Z1999-12-31ArticleDepartmental Bulletin Paper4737506 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.543-55013450069http://hdl.handle.net/10564/56513450069AA11252383Journal of Nara Medical Association506543550jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5662017-06-11T23:20:26Zhdl_10564_1535不安定性骨盤骨折に対する各種 iliosacral screw の三点曲げ強度試験THE THREE-POINT BENDING TESTS OF VERSATILE ILIOSACRAL SCREWS FOR THE TREATMENT OF UNSTABLE PELVIC FRACTURES野阪, 善雅稲田, 有史川西, 弘一前田, 裕仁三野, 浩也宮本, 誠司unstable pelvic fractureiliosacral screwthree-point bending testintensity of screwIt is generally accepted that internal fixation using iliosacral screws for
unstable pelvic fractures is effective. However, the placement of iliosacral screws is
technically demanding and it has been reported that screws can be damaged by the load
from the early part of the postoperative stage. We have reported that the dull insertion
method of placement of iliosacral screws and combination of motor-evoked potential
monitoring can reduce complications, whereas the strength of the iliosacral screws is
unknown. The aims of this study were to measure the strength of screws that we have used
clinically and are being used currently, and to evaluate whether these screws are proper for
use as iliosacral screws. The strength of screws was measured by the three-point bending
test. Screws were divided into four types as follows : a solid screw made of titanium (8.0
mm in diameter) (Screw-A), a cannulated screw made of titanium (8.0 mm in diameter)
(Screw-B), a cannulated screw made of titanium (6.5 mm in diameter) (Screw-C) and a
cannulated screw screw made of stainless steel (7.0 mm in diameter) (Screw-D). Screw
-A is the screw that we have used clinically and the others are screws that are used
currently. Five screws were measured one-by-one per each type and five pairs of Screw-
C were measured. Screw-A samples were not broken; moreover, they withstood loads
exceeding 1000 kgW. Screw-B samples were broken by a load of 320±48.7kgW. Shrew
-C samples were broken by a load of 150±0.0 kgW. Screw-D samples were not broken, but
lost rigidity by a load of 132±8.4 kgW or more. Pairs of Screw-C were broken by a load
of 484±35.1 kgW. In conclusion, Screw-A, which we have used clinically, and pairs of
Screw-C, may be proper material for use as iliosacral screws.奈良医学会2008-11-10T07:44:51Z2008-11-10T07:44:51Z1999-12-31ArticleDepartmental Bulletin Paper1396080 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.551-55913450069http://hdl.handle.net/10564/56613450069AA11252383Journal of Nara Medical Association506551559jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5672017-05-29T06:06:55Zhdl_10564_1535耳介部人咬傷の1手術例A RECONSTRUCTION OF HUMAN BITE INJURY TO THE EAR WITH TISSUE LOSS桑原, 理充波床, 光男多田, 英之田中, 文萬木, 聡真柴, 久実白井, 利彦human biteear (auricular) deformitysurgical treatmentThe incidence of human bite injury to the auricle is relatively rare. We
experienced a case with tissue loss. Six months after the injury, the deformity was
corrected by local flap using residual auricular tissue including cartilage, and an acceptable
result was obtained. In this paper, we present a surgical method of our case, and discuss
the managment of human bite injury to the auricle.奈良医学会2008-11-10T07:53:37Z2008-11-10T07:53:37Z1999-12-31ArticleDepartmental Bulletin Paper1329473 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.560-56413450069http://hdl.handle.net/10564/56713450069AA11252383Journal of Nara Medical Association506560564jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5682017-05-29T06:06:31Zhdl_10564_1535橋本病を合併した特発性血小板減少性紫斑病の1例A CASE OF IDIOPATHIC THROMBOCYTOPENIC PURPURA WITH HASHIMOTO'S THYROIDITIS団野, 大介山野, 繁中谷, 公彦藤井, 謙裕佐々木, 弥寿延藤本, 伸一椎木, 英夫土肥, 和紘中村, 忍ITPHashimoto's thyroiditisprednisoloneWe report a case of idiopathic thrombocytopenic purpura with Hashimoto'
s thyroiditis. A 67-year-old female was admitted to our hospital for bleeding tendency in
December 1992. Laboratory findings were as follows : platelet count was 3,000/mm3, PA
-IgG was 605 ng/10^7 cells, megakaryocyte count in bone marrow examination was 117/μl,
free T3 was 68.8 ng/dl, free T4 was 1.8 μg/dl, TSH was 395.7 μu/ml, anti-thyroglobulin
antibody was ×400, and anti-microsome antibody was ×25,600. The patient was
diagnosed as having idiopathic thrombocytopenic purpura (ITP) with Hashimoto's
thyroiditis. Prednisolone was administered for ITP, and levothyroxine sodium for Ha-
shimoto's thyroiditis. The platelet count increased. Anti-thyroglobulin antibody and anti
-microsome antibody were ×400 and ×25,600 respectively in December 1992. They
became depressed to under ×100 and 25,600 in January 1993, and to under ×100 and under
×100 in July 1997. This case suggests that a common immunological mechanism exists
between ITP and Hashimoto's thyroiditis, and that prednisolone is effective for both
thrombocytopenia due to ITP and hypothyroidism due to Hashimoto's thyroiditis.奈良医学会2008-11-11T06:02:06Z2008-11-11T06:02:06Z1999-12-31ArticleDepartmental Bulletin Paper541691 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.565-56913450069http://hdl.handle.net/10564/56813450069AA11252383Journal of Nara Medical Association506565569jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5692017-05-29T06:06:31Zhdl_10564_1535空腸瘻を形成した横行結腸原発悪性リンパ腫の1例A CASE OF PRIMARY MALIGANANT LYMPHOMA IN THE TRANSVERSE COLON WITH JEJUNAL FISTULA後一, 肇川野, 貴弘西浦, 公章中谷, 公彦藤本, 伸一藤井, 謙裕malignant lymphomatransverse colonfistulaA 55-year-old male complaining of diarrhea was admitted to our hospital.
Colonoscopic findings showed a constrictic lesion with fistula in the transversecolon.
Barium enema revealed a circumferential constriction and jejunal fistula. Partial
colectomy and jejunotomy was perfomed. Histopathological examination of the resected
tissue showed non-Hodgkin, diffuse lymphoma, large celltype.奈良医学会2008-11-11T06:19:19Z2008-11-11T06:19:19Z1999-12-31ArticleDepartmental Bulletin Paper1764659 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.570-57413450069http://hdl.handle.net/10564/56913450069AA11252383Journal of Nara Medical Association506570574jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5702017-05-29T06:06:24Zhdl_10564_153599年度WJEMA夏期総合大会の報告土居, 真太郎West Japan English Medical Assosiation奈良県立医科大学夏期総合大会奈良医学会2008-11-11T06:24:55Z2008-11-11T06:24:55Z1999-12-31ArticleDepartmental Bulletin Paper139072 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.57513450069http://hdl.handle.net/10564/57013450069AA11252383Journal of Nara Medical Association506575575jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5712017-05-29T06:06:31Zhdl_10564_1535第120回奈良医学会 : 学会記事第120回奈良医学会学会記事奈良医学会2008-11-11T06:31:07Z2008-11-11T06:31:07Z1999-12-32ArticleDepartmental Bulletin Paper752057 bytesapplication/pdfJournal of Nara Medical Association Vol.50 No.6 p.576-58213450069http://hdl.handle.net/10564/57113450069AA11252383Journal of Nara Medical Association506576582jpnpublisher