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oai:ginmu.naramed-u.ac.jp:10564/15952017-06-11T23:20:26Zhdl_10564_1594表紙、目次、総目次、投稿規定、奥付(Vol.45 No.6)表紙目次総目次投稿規定奥付奈良医学会2011-08-22T03:26:12Z2011-08-22T03:26:12Z1994-12-31OtherOthers2991315 bytesapplication/pdf奈良医学雑誌 Vol.45 No.60469555013450069http://hdl.handle.net/10564/159504695550AN00180974奈良医学雑誌456jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/15962017-05-29T06:07:30Zhdl_10564_1594小脳出血を契機に発見された急性骨髄性白血病(FAB分類のM4)の1例A CASE OF ACUTE MYELOBLASTIC LEUKEMIA (M4) DETECTED FROM CEREBELLAR HEMORRHAGE森本, 淳詞北岡, 健辻本, 正之笹岡, 保典鎌田, 喜太郎橋本, 俊雄土肥, 和紘acute myeloblastic leukemia (M 4)cerebellar hemorrhagepresenting symptomA 41-year-old man was admitted to our hospital on November 10,1993,complaining of sudden severe headache with vomiting followed by unconsciousness. Emergency brain CT showed massive hemorrhage in the right cerebellar hemisphere,obstructive hydrocephalus and a low density area in the brain stem secondary to compression. Laboratory findings at admission included a hematocrit level of 32.1%,leukocyte count of 109,000/μl with 42% consisting of blast cells,and a platelet count of 18,000/μl. The hemostatic tests were normal except for a prolonged bleeding time. Bone marrow aspiration demonstrated a nuclear cell count of 1,110,000/μl with 43.8% myeloblasts and 21.8% monocytes. Cerebrospinal fluid contained many blast cells. He was diagnosed as having acute myeloblastic leukemia (M 4). Cases of AML detected from intracranial hemorrhage are extremely rare and,to the best of our knowledge,the present case is the first reported case of M 4 detected from intracranial hemorrhage. Regarding the location of the hemorrhage,almost all cases with intracranial hemorrhage were detected from supratentrial hemorrhage,but the present case is the fist reported case detected from cerebellar hemorrhage. The main cause of cerebellar hemorrhage in his case is considered to be invasion of blast cells to the vascular wall. Hyperleukocytosis and thrombocytopenia may have promoted the cerebellar hemorrhage in this case.奈良医学会2011-08-22T04:34:10Z2011-08-22T04:34:10Z1994-12-31ArticleDepartmental Bulletin Paper600041 bytesapplication/pdf奈良医学雑誌 Vol.45 No.6 p.655-6580469555013450069http://hdl.handle.net/10564/159604695550AN00180974奈良医学雑誌456655658jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/15972017-05-29T06:07:30Zhdl_10564_1594集中治療を必要とした周産期重症患者の検討ASSESSMENT OF CRITICALLY PERINATAL ILL PATIENTS WHO REQUIRED INTENSIVE CARE下村, 俊行上田, 康晴呉原, 弘吉岩阪, 友俗福島, 哲志critical perinatal patienttoxemiamultiple organ failurematernal transferThe six cases of critically ill perinatal patients who have been cured in our
intensive care unit during the past three years (April 1991-March 1994) were elucidated
from the viewpoint of Intensive Care Medicine.
Five patients were transferred to our hospital from other institutions. We have successfully treated the following critical conditions,including two patients who suffered from hemorrhagic shock due to postpartum bleeding,abruptio placenta and other causes ; pulmonary edema,HELLP syndrome (syndrome of hemolysis,elevated liver enzymes,and low platelet count),eclampsia,eclampsia with HELLP syndrome. Obstetrical DIC scores
of five patients were all more than 8,a severe degree score,when they arrived at ICU. Three patients required respiratory care with artificial ventilation and one patient was treated by mandatory oxygen inhalation. The patients suffering from hemorrhagic shock were intensively treated with blood transfusion,platelet-infusion and anticoagulation therapy ; also for the patients of eclampsia,anticoagulation therapy and vasodilation therapy were employed for hemodynamic stability. The patients with HELLP syndrome were given platelet infusion and liver supporting therapy ; diuretics were used for renal dysfunction. With aggressive care by co-medical staff in our ICU,all patients were
discharged alive from ICU.
In conclusion,intensive care should be applied to critically ill perinatal patients after definite diagnosis for avoidance of multiple organ failure.奈良医学会2011-08-22T04:57:36Z2011-08-22T04:57:36Z1994-12-31ArticleDepartmental Bulletin Paper617109 bytesapplication/pdf奈良医学雑誌 Vol.45 No.6 p.659-6640469555013450069http://hdl.handle.net/10564/159704695550AN00180974奈良医学雑誌456659664jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/15982017-06-11T23:20:26Zhdl_10564_1594MODULATIONS BY EXTERNAL PH ON ANODAL BREAK EXCITATION IN RABBIT SINO-ATRIAL NODAL CELLSSatoh, Hiroyasuextracellular pHfast Na⁺ channelanodal break excitationvoltage-clampsino-atrial nodal cellsEffects of extracellular pH on anodal break excitation in rabbit sino-atrial (SA) nodal cells were investigated using the two-microelectrode voltage-clamp technique. The method of anodal break excitation was developed by Weidmann²⁸⁾,and is regarded as a measurement of the activity of the fast Na⁺ channel. Increasing external pH from 7.4 to 8.5 enhanced the maximum rate of depolarization by anodal break excitation,as compared with the values of control (at pH 7.4). In contrast,a decline of pH from 7.4 to 5.5 inhibited the maximum rate of depolarization,accompanied with depression in the activity. Acidification shifted the inactivation curves (h∞) of the fast Na⁺ current in the depolarizing
direction,and alkalinization shifted it in the hyperpolarizing direction. These results
suggest that proton would modulate the membrane surface charge of the SA nodal cells,resulting in alteration of the gating kinetics of ionic channels.奈良医学会2011-08-23T03:57:10Z2011-08-23T03:57:10Z1994-12-31ArticleDepartmental Bulletin Paper527062 bytesapplication/pdf奈良医学雑誌 Vol.45 No.6 p.665-6710469555013450069http://hdl.handle.net/10564/159804695550AN00180974奈良医学雑誌456665671engpublisher
oai:ginmu.naramed-u.ac.jp:10564/16082017-05-29T06:09:29Zhdl_10564_1594糖尿病性腎症における尿中糖蛋白分析 : ウエスタンブロッティング分析によるレクチン結合パターンANALYSIS OF URINARY GLYCOPROTEINS FOR DIABETIC NEPHROPATHY : WESTERN BLOTTING ANALYSIS USING PEROXIDASE LABELED LECTINS中島, 靖夫diabetic nephropathyelectrophoretic analysishigh performance lectin affinity chromatographylectinThe aim of this study was to evaluate the clinical usefulness of polyacrylamide gel electrophoresis,followed by reaction with peroxidase-coupled lectins using urinary glycoproteins in 20 patients with diabetic nephropathy. After SDS-polyacrylamide gel electrophoresis (SDS-PAGE),high performance lectin affinity chromatography (HPLAC) and immunoblotting of urinary glycoproteins with α₁-acid glycoprotein (α₁-AG) and α₁-microglobulin (α₁-MG) were performed. The lectins used were derived from Triticum vulgaris (WGA),Phaseolus vulgaris (PHA-E₄),Dolichos biflorus (DBA) and Lens culinaris (LCA),which had a high affinity for β1→4 N-acetyl-D-gulcosamine (GlcNAcβ1→4GlcNAc),N-acetyl-D-galactosamine (GalNAc),α-galactosamine (α-GalNAc) and α-mannose (α-Man) residues,respectively. Electrophoretic patterns of urinary glycoproteins clearly showed the presence of lectin-reactive glycoproteins with molecular weights lower than that of albumin. The molecular weights of the main bands that reacted with WGA,namely PHA-E₄ and LCA,were respectively 50,000 and 38,000 daltons,and increased with the progression of diabetic nephropathy. WGA reacted strongly with many glycoproteins having a wide range of molecular weights. LCA and PHA-E₄ reacted preferentially with glycoproteins of molecular weight lower than 50,000 daltons,but with DBA no reaction was observed. These results suggest that low molecular-weight glycoproteins that are observed in the urine of patients with diabetic nephropathy have abundant carbohydrate residues such as GlcNAc β1→4 GlcNAc,GalNAc and α-Man,and include α₁-AG and α₁-MG. The excretion of low-molecular-weight glycoproteins with high affinities for some lectins suggests organic impairment in diabetic nephropathy.奈良医学会2011-08-24T01:26:31Z2011-08-24T01:26:31Z1994-12-31ArticleDepartmental Bulletin Paper2035748 bytesapplication/pdf奈良医学雑誌 Vol.45 No.6 p.672-6830469555013450069http://hdl.handle.net/10564/160804695550AN00180974奈良医学雑誌456672683jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/16122017-06-11T23:20:26Zhdl_10564_1594口腔領域における交感,感覚および運動神経支配に関する研究 : Ⅰ. 顎関節,阻噂筋における神経支配SYMPATHETIC,SENSORY AND MOTOR INNERVATION IN THE ORAL REGION : Ⅰ. INNERVATION OF THE TEMPOROMANDIBULAR JOINT AND MASTICATORY MUSCLES森本, 佳成temporomandibular jointmasticatory musclesympathetic gangliontrigeminal gangliontrigeminal motor nucleusSympathetic,sensory and motor innervation of the temporomandibular joint (TMJ) and the masticatory muscles was investigated in the rat by use of horseradish peroxidase (HRP) method. In the case of HRP application into TMJ,labeled cells were distributed uniformly in the superior cervical ganglion (SCG). In the trigeminal ganglion (TRG) they were found in the submandibular division. In TRG the mean diameter of labeled cells of TMJ (23.7±5.9μm) was significantly smaller than that of tooth pulp (27.4±5.0μm). Almost no labeling was obtained in SCG after sectioning of the cervical sympathetic plexus. By sectioning of the auriculotemporal nerve,labeling of TMJ was eliminated in SCG and reduced by 1/10 in TRG. The above observation indicated that the sympathetic components which originate
from SCG innervate TMJ through intervention of the auricurotemporal nerve after ascending
along the external carotic plexus ; also,that approximately 90% of the sensory fibers
innervating TMJ are carried by the auricurotemporal nerve,which seems to contain smaller Aδ and C fibers. HRP injection into the masseteric,temporal,medial pterygoid and lateral pterygoid muscles brought ipsilateral numerous labeled cells which localized at the central 1/2 of SCG,but only few cells in the anterior digastric and mylohyoid muscles. Labeled cells were found ipsilaterally in the submandibular division in TRG. The mean diameter of TRG labeled cells in the above muscles (24.3±4.9μm) was significantly smaller than that in tooth pulp. In the trigeminal motor nucleus,labeled cells after HRP injection into the masticatory
muscles were localized in each rostro-caudal level. The distribution pattern of neuron size of the masseteric muscles was bimodal,and that of the others unimodal. The mean
diameter of labeled cells of the masseteric (26.0±4.3μm) and temporal muscles (26.1±4.3μm) was significantly larger than that of the others.奈良医学会2011-08-24T04:05:21Z2011-08-24T04:05:21Z1994-12-31ArticleDepartmental Bulletin Paper1706050 bytesapplication/pdf奈良医学雑誌 Vol.45 No.6 p.684-6980469555013450069http://hdl.handle.net/10564/161204695550AN00180974奈良医学雑誌456684698jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/16132017-06-11T23:20:26Zhdl_10564_1594口腔領域における交感,感覚および運動神経支配に関する研究 : Ⅱ. 顎下腺,舌下腺,耳下腺における神経支配SYMPATHETIC,SENSORY AND MOTOR INNERVATION IN THE ORAL REGION : Ⅱ. INNERVATION OF THE SUBMANDIBULAR,SUBLINGUAL AND PAROTID GLANDS森本, 佳成submandibular glandsublingual glandparotid glandsympathetic gangliontrigeminal ganglionSympathetic and sensory innervation of the submandibular,sublingual and parotid glands,and difference of sensory innervation between the body and duct were studied by horseradish peroxidase (HRP) method. Numerous labeled cells were observed in the ipsilateral superior cervical (SCG) and a few in stellete ganglion (SG) after HRP injection into the submandibular and parotid gland bodies. They were localized at the central 1/2 of SCG. No labeled cells were found in the sympathetic ganglia following sublingual HRP injection. HRP injection into the submandibular,sublingual and parotid gland body brought labeling of small numbers of neurons (1.4,0.6 and 2.2,respectively) in the unilateral trigeminal ganglion (TRG). However,more TRG neurons were labeled after HRP application in the submandibular (7.8±3.4 units) and parotid duct (9.4±3.7 units) than in the gland body. Mean diameter of labeled cells from the duct was significantly smaller (18.6±3.2μm and 18.2±3.4μm,respectively) than that of tooth plup (27.4±5.0μm) or TMJ (23.7±5.9μm). No labeled neurons in SCG were recognized by submandibular gland HRP application after sectioning the facial artery or by parotid HRP injection after cutting the external
carotid artery. Most of the sympathetic components supplying the submandibular or parotid gland originate from SCG and much more limitedly from SG. No sympathetic innervation exists in the sublingual gland. While the sensory innervation of the submandibular and parotid gland bodies is rare,that of their ducts is more dense by C-fibers which may generate a pain
sensation related to the intraductal sialolithiasis. The sympathetic nerve from SCG and SG is supposed to innervate the submandibular or parotid gland via the feeding arteries after arising from the external carotid plexus. They do not pass by way of the lingual nerve or submandibular ganglion for the submandibular gland,or of the auriculotemporal nerve for the parotid gland.奈良医学会2011-08-24T05:01:15Z2011-08-24T05:01:15Z1994-12-31ArticleDepartmental Bulletin Paper1031040 bytesapplication/pdf奈良医学雑誌 Vol.45 No.6 p.699-7070469555013450069http://hdl.handle.net/10564/161304695550AN00180974奈良医学雑誌456699707jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/16142017-05-29T06:07:32Zhdl_10564_1594第115回奈良医学会 : 学会記事第115回奈良医学会学会記事奈良医学会2011-08-25T04:38:45Z2011-08-25T04:38:45Z1994-12-31ArticleDepartmental Bulletin Paper422982 bytesapplication/pdf奈良医学雑誌 Vol.45 No.6 p.708-7120469555013450069http://hdl.handle.net/10564/161404695550AN00180974奈良医学雑誌456708712jpnpublisher