2024-03-28T14:28:52Zhttp://ginmu.naramed-u.ac.jp/dspace-oai/request
oai:ginmu.naramed-u.ac.jp:10564/5802017-05-29T06:06:25Zhdl_10564_1536表紙、目次、投稿規定、奥付(Vol.51.No.1)表紙目次投稿規定奥付奈良医学会2008-11-26T06:56:17Z2008-11-26T06:56:17Z2000-02-29OtherOthers2495472 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.113450069http://hdl.handle.net/10564/58013450069AA11252383Journal of Nara Medical Association511jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5812017-06-11T23:20:26Zhdl_10564_1536THE PROGNOSTIC SIGNIFICANCE OF P53 OVEREXPRESSION IN METASTATIC LYMPH NODES OF ESOPHAGEAL CARCINOMAS AND ASSOCIATION WITH CELL PROLIFERATION AND APOPTOSISYamashita, Junesophageal cancerp53lymph node metastasisPCNAapoptosisThe p53 overexpression is not always correlated with the clinicopathologic
features or clinical outcome of esophageal cancer patients. The incidence of lymph node
metastasis is the most significant prognostic factor, but the molecular genetic events
including p53 overexpression in metastatic lymph node have remained unclear. The aim of
this study was to investigate the prognostic significance of p53 overexpression in lymph
node metastatic tumors in comparison with primary tumors and the relationship between
p53 overexpression and proliferative activity or apoptosis. We performed immunohisto-
chemical analysis for both p53 protein and proliferating cell nuclear antigen (PCNA) and
in situ DNA nick end labeling method to detect apoptosis in 35 primary tumors and 25
metastatic lymph nodes. The p53 overexpression in lymph node metastatic tumors correlat-
ed with shorter survival after operation in lymph node-positive cancer patients (p<0.01).
In primary tumors, there was no statistically significant difference for PCNA labeling index
(LI) and apoptotic LI between p53-positive and negative tumors. In lymph node metastatic
tumors, the PCNA LI of p53-positive tumors was significantly higher than that of p53-
negative tumors (p<0.04), and the apoptotic LI of p53-positive tumors tended to be lower
than that of p53-negative tumors. The p53 overexpression is related to tumor cell prolifera-
tion and inhibition of apoptosis in lymph node metastatic tumors, and p53 overexpression
in metastatic lymph nodes may correlate with the malignant potential of esophageal
carcinoma.奈良医学会2008-11-26T07:00:54Z2008-11-26T07:00:54Z2000-02-29ArticleDepartmental Bulletin Paper2397617 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.1 p.1-1313450069http://hdl.handle.net/10564/58113450069AA11252383Journal of Nara Medical Association511113engpublisher
oai:ginmu.naramed-u.ac.jp:10564/5822017-05-29T06:06:26Zhdl_10564_1536早期胃癌の超音波内視鏡診断ACCURACY OF ENDOSCOPIC ULTRASONOGRAPHY FOR DIAGNOSING THE DEPTH OF EARLY GASTRIC CANCER今津, 博雄野口, 隆一小林, 洋三宮本, 洋二中谷, 敏也中山, 雅樹松井, 勉福井, 博楠本, 祥子鶴井, 裕和頼木, 領山田, 貴佐道, 三郎仲川, 昌之渡辺, 明彦endoscopic ultrasonographyearly gastric cancerThe ability of endoscopic ultrasonography to diagnose the depth of invasion
was investigated in 34 patients with early gastric cancer. The depth of cancer invasion was
classified as the mucosa(m), the submucosa(sm), muscularis propria(mp) and subserosa
and serosa.
The results obtained were as follows;
1) The overall diagnostic accuracy was 62% in all 34 cases ; 60% in m cancers and 67%
in sm cancers, respectively.
2) The diagnostic accuracy of cancer invasion was markedly low in Ⅲ type early
gastrlc cancer.
3) The diagnostic accuracy of cancer invasion was lower in cases with fibrosis ac-
companying peptic ulcer or ulcer scar than in cases without them.奈良医学会2008-11-26T07:11:00Z2008-11-26T07:11:00Z2000-02-29ArticleDepartmental Bulletin Paper2077411 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.1 p.14-1913450069http://hdl.handle.net/10564/58213450069AA11252383Journal of Nara Medical Association5111419jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5832017-06-11T23:20:26Zhdl_10564_1536胃静脈瘤出血に対するα-cyanoacrylate monomer(CA)を用いた内視鏡的硬化療法ENDOSCOPIC INJECTION SCLEROTHERAPY FOR BLEEDING GASTRIC VARICES USING α-CYANOACRYLATE MONOMER今津, 博雄宮本, 洋二小林, 洋三野口, 隆一中谷, 敏也中山, 雅樹松井, 勉福井, 博α-cyanoacrylate monomerendoscopic injection sclerotherapybleeding gastrlc varlcesWe evaluated the efficacy and outcome of endoscopic injection sclerother-
apy (EIS) with α-cyanoacrylate monomer and 5% ethanolamine oleate in 6 patients with
bleeding gastric varices. EIS was performed on an emergency basis in 4 patients and on an
elective basis in 2 patients. Acute bleeding was stopped in 4 patients who received EIS on
emergency basis. No rebleeding was observed in all patients during the follow-up period.
No serious complications, such as embolization in other organs, were observed. The results
suggest that this therapy is a safe and useful treatment for bleeding gastric varices.奈良医学会2008-11-26T07:16:00Z2008-11-26T07:16:00Z2000-02-29ArticleDepartmental Bulletin Paper4223406 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.1 p.20-2713450069http://hdl.handle.net/10564/58313450069AA11252383Journal of Nara Medical Association5112027jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5842017-05-29T06:06:27Zhdl_10564_1536血糖コントロール指標としての血糖自己測定(SMBG)の有用性USEFULNESS OF SELF-MONITORING OF BLOOD GLUCOSE AS AN INDEX OF GLYCEMIC CONTROL IN PATIENTS WITH DIABETES MELLITUS八嶌, 功藤井, 謙裕金内, 雅夫土肥, 和紘diabetes mellitusself-monitoring of blood glucoseglycemic controlWe evaluated the usefulness of self-monitoring of blood glucose (SMBG)
as an index of glycemic control in patients with diabetes mellitus. We instructed 59 patients
with type 2 diabetes mellitus to measure SMBG levels before the morning and evening
meals everyday. SMBG data for 126 continuous days were collected from all patients. We
divided the follow-up period (126 days) into 9 sequential periods and calculated the mean
SMBG for each period of 14 days. We measured HbAic as an index of long-term glycemic
control at the end of follow-up and evaluated the correlation between the value of HbA1c
and the mean SMBG of each period in all patients. The mean SMBG data (MS) from 27
to 14 days before the end of follow-up showed the best correlation with the value of HbA1c.
MS was 112.2±16.8 mg/dl (mean±SD) in the excellent-control group (HbA1c≦6.0%),
127.6±27.4mg/dl in the good-control group (6.0<HbA1c≦7.0%), 144.4±30.4 mg/dl in
the fair-control group (7.0<HbA1c≦8.5%), and 179.7±23.6 mg/dl in the poor-control
group (HbA1c>8.5%). These findings indicate that SMBG is useful as an index of
glycemic control in patients with diabetes mellitus.奈良医学会2008-11-26T07:22:17Z2008-11-26T07:22:17Z2000-02-29ArticleDepartmental Bulletin Paper511983 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.1 p.28-3213450069http://hdl.handle.net/10564/58413450069AA11252383Journal of Nara Medical Association5112832jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5852017-05-29T06:06:35Zhdl_10564_1536ヒト型結核菌に対するマウス系統間における抵抗性及び肺病変の比較COMPARISON OF RESISTANCE AND PATHOLOGIC CHANGES IN THE LUNG AMONG VARIOUS MOUSE STRAINS AFTER INFECTION WITH MYCOBACTERIUM TUBERCULOSIS H37RV油納, 善久IL-12alveolar macrophagenatural resistanceMycobacterium tuberculosislung granulomaBCGFive inbred strains of mice were examined for resistance to intravenous
infection with 10^5 colony-forming units of Mycobacterium tuberculosis H37Rv. Based on the
difference in survival time, five strains were classified into two groups : susceptible (CBA
and DBA/2) and resistant (BALB/c, A/J, C57BL/6) strains. After infection with M.
tuberculosis, mycobacteria rapidly multiplied in the lung with low levels of pulmonary IL-
12 production in CBA mice ; resulting in the progression of necrotic pneumonia. In contrast,
mycobacteria slowly multiplied in association with high levels of IL-12 production in the
lung of C57BL/6 mice ; leading to the development of granulomas. In C57BL/6 mice, the
growth of bacteria was suppressed over a long period (6th-24th weeks) after infection, and
granulomatous response in the lung was followed by progressive fibrosis capable of prevent-
ing bacterial dissemination. When alveolar macrophages from both strains were infected
in vitro with M. tuberculosis at a ratio of 1 : 10, the degree of phagocytic activity was not
different between two strains, but C57BL/6 cells displayed higher anti-mycobacterial
activity compared to CBA cells. These results suggest that murine natural resistance
against M. tuberculosis depends on the anti-mycobacterial activity of alveolar macrophages,
and the early production of IL-12 in the lung upon infection appears to be associated with
the innate resistance and subsequent induction of M. tuberculosis-specific immunity.
Moreover, vaccination with BCG was effective in reducing bacterial growth in both mouse
strains during the initial phase of infection, while its effect was expressed in only resistant
mice as the retardation of histopathologic progression during the late phase.奈良医学会2008-11-26T07:26:10Z2008-11-26T07:26:10Z2000-02-29ArticleDepartmental Bulletin Paper5715293 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.1 p.33-4513450069http://hdl.handle.net/10564/58513450069AA11252383Journal of Nara Medical Association5113345jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5862017-05-29T06:06:27Zhdl_10564_1536通過静脈皮弁移植の実験的研究とその臨床応用EXPERIMENTAL STUDIES OF THE FLOW-THROUGH VENOUS FLAP AND ITS CLINICAL APPLICATIONS平井, 利幸福居, 顕宏玉井, 進稲田, 有史venous flapexperimental studyrabbitsclinical casesIn recent years, conventional flaps which make a sacrifice of main arteries
as reported frequently in the early stage of their development have been reevaluated in the
field of flap surgery. This movement has facilitated development of flaps vascularized by
perforating branches measuring about 0.3 mm in diareter, and has also thrown light on the
merits of venous flaps which make no sacrifice of main arteries. Looking back on the
history of venous flaps, they initially attracted attention because, in contrast to conven-
tional flaps, 1) they do not make a sacrifice of main arteries, 2) they are not limited by
the conditions of the recipient site, and 3) preparation of the flap is technically easy and
applicable to emergency operations. Because of these advantages, venous flaps have been
used widely in the clinical setting, but the mechasism of flap survival remains conjectural.
The present study was designed to determine the limits of venous flap viability supplied by
one vein, which is one of the questions related to venous flap stirvival. A flom-through
venous flap measuring 3.0×3.0 cm was prepared in the lateral margin of the auricle in
rabbits, and the area of flap viability was determined. The influences of surrounding blood
circulation on the area of flap viability were also investigated. As a result the width of flap
covered by one vein was 11.0±4.8 mm as a whole, whereas it was 18.1±6.2 mm in the
presence of good blood circulation in the surroundings, showing a significant effect of
surrounding blood circulation. Based on these experimental data, flow-through venous
flaps were applied to 25 patients and the stability of the flaps was confirmed. The presence
of arteriolar systems in perivenous tissues has been demonstrated recently. To provide the
venous flap with blood flow from the arteriolar system is another way to improve the
viability of venous flaps.奈良医学会2008-11-26T07:31:15Z2008-11-26T07:31:15Z2000-02-29ArticleDepartmental Bulletin Paper5138476 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.1 p.46-5913450069http://hdl.handle.net/10564/58613450069AA11252383Journal of Nara Medical Association5114659jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5872017-05-29T06:06:35Zhdl_10564_1536CAPDに合併した胸水貯留に対して自己血注入による胸膜癒着術が有効であった1例A CASE OF HYDROTHORAX IN A PATIENT UNDERGOING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS WHO WAS TREATED WITH AUTOLOGOUS BLOOD PLEURODESIS川野, 貴弘京田, 有輔団野, 大介中川, 陽子山路, 國弘丸山, 直樹久我, 由紀子西岡, 久之後一, 肇西浦, 公章continuous ambulatory peritoneal dialysishydrothoraxautologous blood pleurodesisWe report a case of hydrothorax in a patient undergoing continuous
ambulatory peritoneal dialysis (CAPD) who was treated with autologous blood pleurodesis.
A 46-year-old woman with end-stage renal failure due to IgA nephropathy started CAPD
on February 9, 1994. After 19 days, she was admitted to our hospital because of dyspnea.
A chest X-ray revealed right pleural effusion. Pleuroperitoneal communication was
diagnosed because the glucose concentration in the pleural fluid was high compared with
that in her blood. Autologous blood pleurodesis was performed after drainage of the pleural
effusion. After 4 weeks, CAPD was restarted, and hydrothorax did not recur. Autologous
blood pleurodesis may be useful in the treatment of hydrothorax in a patient receiving
CAPD.奈良医学会2008-11-26T07:37:39Z2008-11-26T07:37:39Z2000-02-29ArticleDepartmental Bulletin Paper718744 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.1 p.60-6313450069http://hdl.handle.net/10564/58713450069AA11252383Journal of Nara Medical Association5116063jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5882017-05-29T06:06:29Zhdl_10564_1536腹部造影CTとカラードプラエコーが診断に有用であった腎梗塞の2例THE EFFICACY OF ABDOMINAL ENHANCED CT SCAN AND COLOR DOPPLER ULTRASOUND FOR DIAGNOSIS OF RENAL INFARCTION: A REPORT OF TWO CASES那須, 賢哉林, 照剛勝山, 慶之酢谷, 俊夫中野, 智幸平井, 純川本, 篤彦土肥, 和紘renal infarctionabdominal enhanced CT scancolor Doppler ultrasoundWe report two cases of renal infarction. Case 1 involved a 49-year-old man
wht complained of left back pain. Case 2 involved a 50-year-old woman who had suffered
from hypertension for ten years and had experienced a myocardial infarction 5 years
previously and a cerebral infarction 4 years before her admission with right flank pain.
In both cases, contrast-enhaneed CT scan and color Doppler ultrasound demonstrated a
hypoperfused area of the kidney, and both patients were diagnosed with renal infarction.
Urokinase and heparin were administered intravenously in both cases. In case 1, contrast
-enhanced CT scan and color Doppler ultrasound performed one week after admission
revealed improved arterial blood flow in the infarct area. In case 2, the same tests
performed after one week demonstrated no improvement in renal arterial blood flow.
In conclusion, contrast-enhanced CT scan and color Doppler ultrasound are useful in
distinguishing renal infarction from other forms of acute abdomen.奈良医学会2008-11-26T07:44:05Z2008-11-26T07:44:05Z2000-02-29ArticleDepartmental Bulletin Paper9144884 bytesapplication/pdfJournal of Nara Medical Association Vol.51 No.1 p.64-6913450069http://hdl.handle.net/10564/58813450069AA11252383Journal of Nara Medical Association5116469jpnpublisher