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oai:ginmu.naramed-u.ac.jp:10564/5972017-06-11T23:20:26Zhdl_10564_1538表紙、目次、投稿規定、奥付(Vol.51 No.3)表紙目次投稿規定奥付奈良医学会OtherOthersapplication/pdfJournal of Nara Medical Association Vol.51 No.313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/597Journal of Nara Medical Association, 51(3)http://hdl.handle.net/10564/597http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/597/1/000p.%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%28Vol.51_No.3%29.pdf13450069AA11252383Journal of Nara Medical Association5132000-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5982017-05-29T06:06:35Zhdl_10564_1538コラゲナーゼ脳内出血モデルCOLLAGENASE INDUCED INTRACEREBRAL HEMORRHAGE IN RATS米澤, 泰司榊, 寿右橋本, 宏之intracerebral hemorrhagecollagenaseratsIn contrast to cerebral ischemia, there have been few experimental sdudies
on intracerebral hemorrhage (ICH), alth6ugh ICH is one of the most important cerebral
vascular diseases, as much so as cerebral infarction. In 1990, Rosenberg and coworkers
developed an elegant rat model in which intrastriatal injection of bacterial collagenase
causes bleeding into the brain tissue. This model is considered to be a reproducible method
to induce a hematoma and to regulate its size depending on the amount of collagenase
injected. But this reproducibility has never been discussed ; we made a modified collagenase
induced ICH model in order to verify the reliability of this model.
A total 56 of adult male rats were studied. 2μl artificial cerebropinal fluid, which was
adjusted to a pH 7.4 by buffer, containing 0.25 unit bacterial collagenase was stereo-
tactically injected into the left caudoputamen in 28 rats. The remaining 28 rats were
injected with 0.5 unit bacterial collagenase under the same procedure. Volumetry was
performed at 2, 4, 12, 24, 48, 168, and 720 hours after injection to compare the difference
between groups and observe the natural history of the hematoma.
At 4 hours after injection there was a marked hematoma within the caudoputamen which
stopped developing in size by 24 hours. At 24 hours, 0.25 unit collagenase caused 60μl
hematoma and 0.5 unit collagenase caused 100μl hematoma. At 1 week, the hematoma
was resolving and reduced the size to 35% of the maximum value. At 1 month, the
hematoma represented a slit-like appearance accompanying the atrophy of ipsilateral
hemisphere. The hematoma of 0.5 unit collagenase was significantly larger than that of
0.25 unit collagenase for the entire experimental period. But there was no difference
between the groups concerning the time course of hematoma.
We conclude that our modified collagenase induced ICH model is quite reproducible and
most suitable for the study of ICH. This model should therefore be used for further
investigation of ICH.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.51 No.3 p.139-14413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/598Journal of Nara Medical Association, 51(3): 139-144http://hdl.handle.net/10564/598http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/598/1/139-144p.%e3%82%b3%e3%83%a9%e3%82%b2%e3%83%8a%e3%83%bc%e3%82%bc%e8%84%b3%e5%86%85%e5%87%ba%e8%a1%80%e3%83%a2%e3%83%87%e3%83%ab.pdf13450069AA11252383Journal of Nara Medical Association5131391442000-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/5992017-05-29T06:06:55Zhdl_10564_1538フローサイトメトリー法による末梢血骨髄系樹状細胞検出法の考察DETECTION OF PERIPHERAL BLOOD MYELOID DERIVED DENDRITIC CELLS BY FLOW CYTOMETRY塚口, 信彦peripheral blood dendritic cellflow cytometryhematologic malignancyDendritic cells are strong antigen-presenting cells. Recently, antitumor
immunity therapy using dendritic cells (DC therapy) has received attention. The clinical
study of DC therapy for malignant diseases has been undertaken, and both cases of being
effective responded and tumor-specific CTL-induced have been reported. However, no
specific procedure for DC therapy has yet been established, so further detailed investigation
is necessary. To perform a clinical study of such cell therapy, the technique for detecting
and determining the cells to be used is critical. In this study, we devised a technique of
deetecting peripheral myeloid dendritic cells by three-color flow cytometry. Gates were set
for HLA-DR^+/CD33^+/CD14^- CD16^- CD34^- cells to determine one hundred thousands
collected cells, leading to the clear identification of a cell population as being myeloid
dendritic cells. The surface characteristics of this cell population were determined to be
negative for CD3, CD19 and CD56, positive for CD2 and CD4, weakly positive for CD5,
positive for CD11a and CD11c, negative to weakly positive for CD11b, negative for CD1a,
CD80 and CD83, and positive for CD86. Such characteristics agree well with those previous-
ly reported for peripheral myeloid dendritic cells. Thus, peripheral myeloid dendritic cells
were judged to have been identified by this technique. The proportion of myeloid dendritic
cells in normal subjects was 0.74±0.17%, with absolute numbers of 17.54±5.80/μl. In
patients with chronic CML, incipient or recurrent malignant lymphoma, and acute leukemia
in remission phase, the proportion of myeloid dendritic cells was reduced, suggesting a
decrease in immunologic surveillance function. In patients with malignant lymphoma,
following autologous peripheral blood stem cell transplantation, the proportion of myeloid
dendritic cells was increased, representing the clinical effect of immunotherapy by
autologous peripheral blood stem cell transplantation. This technique can readily deter-
mine exact numbers of peripheral myeloid dendritic cells and will contribute to the future
study of dendritic cells and the development of DC therapy.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.51 No.3 p.145-15613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/599Journal of Nara Medical Association, 51(3): 145-156http://hdl.handle.net/10564/599http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/599/1/145-156p.%e3%83%95%e3%83%ad%e3%83%bc%e3%82%b5%e3%82%a4%e3%83%88%e3%83%a1%e3%83%88%e3%83%aa%e3%83%bc%e6%b3%95%e3%81%ab%e3%82%88%e3%82%8b%e6%9c%ab%e6%a2%a2%e8%a1%80%e9%aa%a8%e9%ab%84%e7%b3%bb%e6%a8%b9%e7%8a%b6%e7%b4%b0%e8%83%9e%e6%a4%9c%e5%87%ba%e6%b3%95%e3%81%ae%e8%80%83%e5%af%9f.pdf13450069AA11252383Journal of Nara Medical Association5131451562000-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/6002017-06-11T23:20:26Zhdl_10564_1538Immune-Mediated Cytotoxicity に対するグリチルリチンの作用EFFECTS OF GLYCYRRHIZIN ON IMMUNE-MEDIATED CYTOTOXICITY豊原, 眞久apotoslsglycyrrhizincytotoxic T lymphocyteFas antlgentumor necrosis factor alpha (TNFα)Intravenous administration of glycyrrhizin (GL) is known to decrease
elevated plasma transaminase levels in patients with chronic viral hepatits, in which
immune-mediated cytotoxicity by cytotoxic T lymphocytes and tumor necrosis factor
alpha (TNFα) is considered to play an important pathogenic role. However, im-
munological interpretation of the transaminase-lowering action by GL is not clear. Studies
were made to elucidate this action immunologically by assessing the effects of GL on
immune-mediated cytotoxicity using an antigen specific murine CD4^+ T cell line, which
exhibits cytotoxicity against antigen presenting cells (APCs) after stimulation with specific
antigen, and two cell lines sensitive to TNFα, a murine fibroblast line and a human
hepatoblastoma line. GL suppressed the cytotoxic activity of the T cells against APCs and
also inhibited TNFα-induced cytotoxicity in both of these TNFα-sensitive cell lines in
vitro. These results suggest that the decrease of elevated transaminase level by GL in
patients with chronic viral hepatitis is mediated in part by inhibition of immune-mediated
cytotoxicity against hepatocyte.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.51 No.3 p.157-16813450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/600Journal of Nara Medical Association, 51(3): 157-168http://hdl.handle.net/10564/600http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/600/1/157-168p.Immune-Mediated_Cytotoxicity_%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e3%82%b0%e3%83%aa%e3%83%81%e3%83%ab%e3%83%aa%e3%83%81%e3%83%b3%e3%81%ae%e4%bd%9c%e7%94%a8.pdf13450069AA11252383Journal of Nara Medical Association5131571682000-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/6012017-05-29T06:06:55Zhdl_10564_1538主膵管と交通のある巨大膵仮性嚢胞がエコーガイド下経皮的ドレナージで消失した1症例A CASE OF GIANT PANCREATIC PSEUDOCYST COMMUNICATING WITH THE MAIN PANCREATIC DUCT TREATED SUCCESSFULLY BY ULTRASONOGRAPHY-GUIDED PERCUTANEOUS DRAINAGE山路, 國弘藪田, 育男坂口, 泰弘小川, 修二辻本, 伸宏中川, 義仁富永, 環小林, 良幸安田, 徳基林, 需福本, 晃久瀧, 順一郎吉田, 英晃藤本, 眞一chronic pancreatitispancreatic pseudocystpercutaneous drainageA 37-year-old man was referred to our hospital because of left hypochon-
dralgia. He was diagnosed as having chronic pancreatitis with a pancreatic pseudocyst,
measuring approximately 8×1O×12 cm, located in the pancreatic tail. After two weeks of
conservative medical treatment, the pancreatic pseudocyst had not decreased in size and
left hypochondralgia persisted. We then performed percutaneous aspiration and drainage
of the cyst guided by ultrasonography. A brownish fluid, 600 ml in volume, was aspirated
and the cyst disappeared completely about three months after the drainage. On the basis
of a review of the literature and our own experience, we believe that percutaneous drainage
should be a first choice for the management of pancreatic pseudocysts that require inter-
ventional therapy.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.51 No.3 p.169-17613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/601Journal of Nara Medical Association, 51(3): 169-176http://hdl.handle.net/10564/601http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/601/1/169-176p.%e4%b8%bb%e8%86%b5%e7%ae%a1%e3%81%a8%e4%ba%a4%e9%80%9a%e3%81%ae%e3%81%82%e3%82%8b%e5%b7%a8%e5%a4%a7%e8%86%b5%e4%bb%ae%e6%80%a7%e5%9a%a2%e8%83%9e%e3%81%8c%e3%82%a8%e3%82%b3%e3%83%bc%e3%82%ac%e3%82%a4%e3%83%89%e4%b8%8b%e7%b5%8c%e7%9a%ae%e7%9a%84%e3%83%89%e3%83%ac%e3%83%8a%e3%83%bc%e3%82%b8%e3%81%a7%e6%b6%88%e5%a4%b1%e3%81%97%e3%81%9f1%e7%97%87%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5131691762000-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/6022017-05-29T06:06:36Zhdl_10564_1538胸骨前再建術を施行された脳梗塞患者に再建胃管より腸瘻を造設した1例A CASE OF CEREBRAL INFARCTION TREATED BY PERCUTANEOUS ENDOSCOPIC GASTRO-JEJUNOSTOMY AT A RECONSTRACTED GASTRIC TUBE THROUGH ANTHETHORAX後一, 肇丸山, 直樹山路, 國弘川野, 貴弘西浦, 公章小泉, 和昭紀川, 伊敏南, 繁敏小川, 修二法田, 浩一percutaneous endoscopic gastrojejunostomy (PEGJ)esophageal cancerasplratlon pneumonlaA 61-year-old man, who was operated for esophageal cancer at the age of
60, was admitted to our hospital because of poor consciousness. After admission, he was
treated by percutaneous endoscopic gastrojejunostomy (PEGJ) at a gastric tube because of
aspiration pneumonia. After PEGJ placement, he did not suffer from aspiration pneumonia
and was discharged from our hospital. Percutaneous endoscopic gastrostomy (PEG) is a
very useful method but can not be performed on the patient with the partial or total resected
stomach. Percutaneous endoscopic jejunostomy (PEJ) is performed on these patients, but
the procedure is difficult for a general endoscopist. Therefore we think that it is easy and
safe for a general endoscopist to perform PEGJ on the patient whose stomach is recostruct-
ed with a gastric tube through anthethorax after resection of esophageal cancer.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.51 No.3 p.177-18013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/602Journal of Nara Medical Association, 51(3): 177-180http://hdl.handle.net/10564/602http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/602/1/177-180p.%e8%83%b8%e9%aa%a8%e5%89%8d%e5%86%8d%e5%bb%ba%e8%a1%93%e3%82%92%e6%96%bd%e8%a1%8c%e3%81%95%e3%82%8c%e3%81%9f%e8%84%b3%e6%a2%97%e5%a1%9e%e6%82%a3%e8%80%85%e3%81%ab%e5%86%8d%e5%bb%ba%e8%83%83%e7%ae%a1%e3%82%88%e3%82%8a%e8%85%b8%e7%98%bb%e3%82%92%e9%80%a0%e8%a8%ad%e3%81%97%e3%81%9f1%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5131771802000-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/6032017-05-29T06:06:36Zhdl_10564_1538高度の肺高血圧を合併した高齢者慢性肺動脈血栓閉塞症の1例A CASE OF CHRONIC PULMONARY EMBOLISM WITH SEVERE PULMONARY HYPERTENSION IN AN ELDERLY PATIENT那須, 賢哉松倉, 康夫藤井, 厚史西田, 育功藪田, 育男野中, 秀郎山野, 繁土肥, 和紘chronic pulmonary embolismelderlypulmonary hypertensionA 76-year-old female was admitted to our hospital because of dyspnea on
effort. She had suffered from hypertension for nine years and had a sudden onset of
dyspnea a year and five months before admission. A chest reontgenogram showed marked
enlargement of the cardiac shlhouette. Chest enhanced CT study revealed that an embolism
in the right main pulmonary artery had caused stenosis. However, pulmonary angiographic
study suggested that embolism was questionable. The pulmonary arterial pressure was 100
/30 mmHg and the right ventricular pressure was 112/10 mmHg Lung scan test showed
mismatched defects between abnormal perfusion scanning and normal ventilation scanning.
Venous ultrasound imaging revealed thrombosis in the popliteal vein. The patient was
diagnosed as having chronic pulmonary embolism due to deep vein thrombosis. She had
been taking warfarin as anticoagulant thrapy.
We believe this was a case of chronic pulmonary embolism. In elderly patients with
sudden onset of dyspnea, chest enhanced CT study is necessary for the accurate diagnosis
of chronic pulmonary embolism.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.51 No.3 p.181-18513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/603Journal of Nara Medical Association, 51(3): 181-185http://hdl.handle.net/10564/603http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/603/1/181-185p.%e9%ab%98%e5%ba%a6%e3%81%ae%e8%82%ba%e9%ab%98%e8%a1%80%e5%9c%a7%e3%82%92%e5%90%88%e4%bd%b5%e3%81%97%e3%81%9f%e9%ab%98%e9%bd%a2%e8%80%85%e6%85%a2%e6%80%a7%e8%82%ba%e5%8b%95%e8%84%88%e8%a1%80%e6%a0%93%e9%96%89%e5%a1%9e%e7%97%87%e3%81%ae1%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5131811852000-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/6042017-05-29T06:06:58Zhdl_10564_1538Swan-Ganzカテーテルによる肺動脈損傷の1例A CASE OF PULMONARY ARTERY RUPTURE INDUCED BY SWAN-GANZ CATHETER中谷, 秀隆土肥, 直文林, 照剛藤田, 泰三橋本, 俊雄土肥, 和紘酢谷, 俊夫平井, 純hemoptysispulmonary artery ruptureSwan-Ganz catheterAn accidental rupture of the pulmonary artery is reported in a 72-year-old
woman. On November 8, 1997, she was admitted for acute myocardial infarction. Marked
ST segment elevation in Ⅰ, aVL, Ⅱ, aVF and V2 from V6 were evident by electrocardiogra-
phy. Cardiac catheterization showed a normal coronary artery with left ventricular failure.
During the procedure, the patient received an initial bolus injection of 10,000 IU of heparin.
A size 7 Fr Swan-Ganz catheter was inserted without difficulty. Mean pulmonary artery
wedge pressure was 14 mmHg. After catheterization, immediately after the balloon was
inflated for a PAWP measurement at the bedside, the patient developed a cough followed
by massive hemoptysis. The possibility of a pulmonary artery rupture was considered.
Protamine was injected through the distal port of the pulmonary artery catheter. After 2
hours, the patient had no further hemoptysis. Pulmonary artery rupture due to the use of
a Swan-Ganz catheter is rare, with an estimated 0.001 to 0.47% incidence rate. Because
such a rupture is fatal in almost 50% of cases, it is important to prevent such complications
during the use of Swan-Ganz catheters.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.51 No.3 p.186-19013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/604Journal of Nara Medical Association, 51(3): 186-190http://hdl.handle.net/10564/604http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/604/1/186-190p.Swan-Ganz%e3%82%ab%e3%83%86%e3%83%bc%e3%83%86%e3%83%ab%e3%81%ab%e3%82%88%e3%82%8b%e8%82%ba%e5%8b%95%e8%84%88%e6%90%8d%e5%82%b7%e3%81%ae1%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5131861902000-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/6052017-05-29T06:06:36Zhdl_10564_1538心室頻拍にメチルプレドニゾロン・パルス療法が奏功した心サルコイドーシスの1例A CASE OF CARDIAC SARCOIDOSIS WITH SUSTAINED VENTRICULAR TACHYCARDIA SUCCESSFULLY TREATED BY METHYLPREDONISOLONE PULSE THERAPY木田, 順富中嶋, 民夫山本, 広光坂口, 泰弘椎木, 英夫橋本, 俊雄土肥, 和紘藤本, 眞一cardiac sarcoidosismethylpredonisolone pulse therapysustained vntricular tachycardiaA 63-year old woman was admitted because of ventricular tachycardia and
congestive heart failure. A chest radiograph showed cardiomegaly and bilateral hilar
lymphadenopathy. Echocardiogram showed diffuse left ventricular hypokinesis, dilated left
ventricle and thinning of the interventricular septum. On gallium scintigram gallium was
accumulated in the heart, especially in the left ventricle. Although endomyocardial biopsy
revealed non-specific fibrosis, cardiac sarcoidosis was clinically suspected. On the 10th day
of the addmission, multiple episodes of sustained ventricular tachycardia appeared. As it
was refractory to lidocaine infusion, methylpredonisolone pulse therapy was initiated,
which abated ventricular tachycardia. Corticosteroid was gradually tapered off and
ventricular tachycardia never recurred. Methylpredonisolone pulse therapy could be a
therapeutic option for cardiac sarcoidosis with fatal arrhythmia even if histological evi-
dence of cardiac sarcoidosis is absent.奈良医学会ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.51 No.3 p.191-19813450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/605Journal of Nara Medical Association, 51(3): 191-198http://hdl.handle.net/10564/605http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/605/1/191-198p.%e5%bf%83%e5%ae%a4%e9%a0%bb%e6%8b%8d%e3%81%ab%e3%83%a1%e3%83%81%e3%83%ab%e3%83%97%e3%83%ac%e3%83%89%e3%83%8b%e3%82%be%e3%83%ad%e3%83%b3%e3%83%bb%e3%83%91%e3%83%ab%e3%82%b9%e7%99%82%e6%b3%95%e3%81%8c%e5%a5%8f%e5%8a%9f%e3%81%97%e3%81%9f%e5%bf%83%e3%82%b5%e3%83%ab%e3%82%b3%e3%82%a4%e3%83%89%e3%83%bc%e3%82%b7%e3%82%b9%e3%81%ae1%e4%be%8b.pdf13450069AA11252383Journal of Nara Medical Association5131911982000-06-30jpnpublisher