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oai:ginmu.naramed-u.ac.jp:10564/19002017-06-11T23:20:26Zhdl_10564_1899表紙、目次、投稿規定、奥付(Vol.43 No.3)表紙目次投稿規定奥付奈良医学会2012-01-19T08:11:39Z2012-01-19T08:11:39Z1992-06-30OtherOthers1856283 bytesapplication/pdf奈良医学雑誌 Vol.43 No.30469555013450069http://hdl.handle.net/10564/190004695550AN00180974奈良医学雑誌433jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/19012017-05-29T06:07:51Zhdl_10564_1899末期腎不全を呈した二分脊椎症による神経因性膀胱の2例END-STAGE RENAL FAILURE BY NEUROGENIC BLADDER IN SPINA BIFIDA PATIENTS : A REPORT OF TWO CASES百瀬, 均高橋, 省二安川, 元信吉井, 将人山本, 雅司末盛, 毅山田, 薫塩見, 努夏目, 修renal failurespina bifidaneurogenic bladderWe report two cases of neurogenic bladder due to spina bifida which resulted in end-stage renal failure, and critically review their clinical courses. The following were concluded to be important for successful urological management of spina bifida patients. First, urological management should be initiated as soon after birth as possible ; this requires adequate recognition by the physician of the presence of the concomitant neurogenic bladder. Second, once renal parenchymal damage appears, not only management of the urinary tract, but also general management, i. e. diet therapy etc., should be initiated in order to prevent the progress of the renal dysfunction. We also emphasize the closer follow-up is necessary for patients in their adolescence when they are required to start self-management of their handicaps including neurogenic bladder.奈良医学会2012-01-19T08:35:14Z2012-01-19T08:35:14Z1992-06-30ArticleDepartmental Bulletin Paper739465 bytesapplication/pdf奈良医学雑誌 Vol.43 No.3 p.181-1870469555013450069http://hdl.handle.net/10564/190104695550AN00180974奈良医学雑誌433181187jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/19022017-05-29T06:07:51Zhdl_10564_1899顎関節内障クローズドロック症例に対する保存療法の検討EVALUATION OF CONSERVATIVE TREATMENTS FOR CLOSED-LOCK CASES OF TEMPOROMANDIBULAR JOINT DYSFUNCTION吉田, 真澄川上, 哲司匠原, 悦雄湯村, 典子都築, 正史高山, 賢一高崎, 真一辰巳, 佳正細井, 栄二杉村, 正仁closed-lockinternal derangementconservative therapyIn our clinic, the rate of patients with temporomandibular joint (TMJ) dysfunctions amounted to 12% of all new outpatients in 1989. This report deals with general clinical aspects concerning the gender and age distribution of the TMJ patients of 1989, and evaluation of the conservative therapies which were used in the closed-lock (anterior disk displacement without reduction) cases in that year. Three hundreds eight cases of TMJ dysfunction were classified according to the criteria of the TMJ workshop 1988 : Type Ⅰ (masticatory muscle disorder)/50 cases (17%) : Type Ⅱ (traumatic arthritis)/13 cases (4%) : Type Ⅲ (internal derangement)/238 cases (76%) :
Type Ⅳ (osteoarthrosis)/7 cases (2%) : and Type Ⅴ (psychic facter)/no cases (0%). Among the Type Ⅲ patient, 103 cases were diagnosed as closed-lock and conservative
therapies (manipulation, manipulation assisted by pumping, and splint therapy) were
performed. The efficacy of the treatment was evaluated from the viewpoint of patients'
age, gender, and the periods of closed-lock before the first visit. Prognosis of the treatment was significantly associated with the gender, age, uni-or bilaterality, and history of the illness ; the symptoms of male, younger, and unilateral closed-lock patient improved faster than those of female, older and bilateral ones. Cases with shorter duration of closed-lock were observed to be more susceptible to treatment than longer ones.奈良医学会2012-01-20T06:48:34Z2012-01-20T06:48:34Z1992-06-30ArticleDepartmental Bulletin Paper880517 bytesapplication/pdf奈良医学雑誌 Vol.43 No.3 p.188-1940469555013450069http://hdl.handle.net/10564/190204695550AN00180974奈良医学雑誌433188194jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/19032017-05-29T06:07:51Zhdl_10564_1899教室における大腸癌症例の検討-第二報 : 手術成績および遠隔治療成績EVALUATION OF SURGICAL THERAPY FOR COLORECTAL CANCER仲川, 昌之藤井, 久男山本, 克彦佐道, 三郎山本, 雅敏渡邉, 巌安田, 慎治吉川, 周作中嶋, 寿内藤, 梓中野, 博重colorectal cancersurgical outcomeDuring the 18-year period from 1972 through 1990, 498 patients were admitted to our clinic for colorectal cancer. Dividing the patients into two groups (one included the cases of the first 10-year period which were mainly operated with "R2" lymphnode cleaning, and the another included cases of the latter 8 years with "R3" lymphnode cleaning), we evaluated the variation of the outcome of surgical treatment comparing the results of the two periods. The results were as follows : 1. The resection rates were elevated in both colonic and rectal cancer (82.5% to 98.6% and 89.5% to 95.8%, respectively). The curative resection rates also increased (colon : from 56.3% to 77.3%, rectum : from 74.6% to 86.6%) 2. The surgical mortality rates decreased from 2.6% to 0.8%. 3. Noncurative resections were caused by hepatic metastasis (61%), peritoneal dissemination (26%), distant metastasis excluding the liver (11.8%), locally far advanced extension (11.8%) and exceeding spread of lymphnode metastasis (10.5%) 4. The overall 5-year survival rates increased in colonic and rectal cancer (52.5% to 64.3% and 40.8% to 67.3%, respectively), and also improved with regard to curatively operated cases (73.4% to 78.6% and 54.5% to 81.9%, respectively). The survival rates by Dukes' classification revealed improvement in Dukes B and C of rectal cancer cases. According to stage classification, stage Ⅲ and Ⅳ had changes for the better. 5. Recurrences of curatively resected cases occurred in 83.3% within 2 years after primary operations, but no reccurrence was recognized in those cases after 5 years. 6. The incidence of sphincter saving operations for lower rectal cancer ("Ra-Rb") was elevated from 11.4% to 35.1%. The survival rates showed no significant difference between sphincter saving operation and abdominoperoneal resection in both periods.奈良医学会2012-01-20T07:49:50Z2012-01-20T07:49:50Z1992-06-30ArticleDepartmental Bulletin Paper1131544 bytesapplication/pdf奈良医学雑誌 Vol.43 No.3 p.195-2060469555013450069http://hdl.handle.net/10564/190304695550AN00180974奈良医学雑誌433195206jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/19042017-06-11T23:20:26Zhdl_10564_1899脾梗塞をおこした先天性Antithrombin Ⅲ(AT Ⅲ)欠乏症Type Ⅰの一家系TYPE Ⅰ ANTITHROMBIN Ⅲ (AT Ⅲ) DEFICIENCY WITH SPLENIC INFARCTION鞠子, 眞済田中, 妥永子橋本, 和子吉田, 裕慈高橋, 幸博吉岡, 章福井, 弘竹内, 雅春splenic infarctionantithronbin Ⅲ deficiencyA family with inherited antithrombin Ⅲ (AT Ⅲ) deficiency is reported. The propositus was a 28-year-old male who first suffered from abdominal pain without any trigger at the age of 27. He was admitted to the hospital because of splenomegaly and splenic infarction and diagnosed as having splenic vein thrombosis. At the age of 28, he suffered a recurrence of abdominal pain accompanied by multiple pulmonary infarction.
Most physical findings were normal. Laboratory blood count and blood chemistry examination revealed no significant abnormality. A detailed coagulation study revealed that both the activity and antigen of plasma ATⅢ were lower than those of normal adults. The ATⅢ levels of his mother, sisters, brother and niece were also decreased. The results of other coagulation tests such as those for heparin cofactor Ⅱ, Protein C, Protein S, and α₁-antitrypsin were essentially normal. The mobility of the patient's ATⅢ in the heparinized agarose gel on two dimensional crossed immunoelectrophoresis was identical to that of normal controls. These findings indicate that the family members possessed the Type Ⅰ ATⅢ deficiency described by Nagy.奈良医学会2012-01-23T06:22:36Z2012-01-23T06:22:36Z1992-06-30ArticleDepartmental Bulletin Paper728470 bytesapplication/pdf奈良医学雑誌 Vol.43 No.3 p.207-2120469555013450069http://hdl.handle.net/10564/190404695550AN00180974奈良医学雑誌433207212jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/19052017-05-29T06:07:51Zhdl_10564_1899小児腎疾患における尿中安定化フィブリン分解産物(XLFbDP)の動態に関する研究 :第2報 尿中FDP分画と糸球体内フィブリン/フィブリノーゲン関連抗原(FRA)についてSTUDIES ON URINARY CROSSLINKED FIBRIN DEGRADATION PRODUCTS (XLFbDP) IN CHILDREN WITH RENAL DISEASES : 2. FRAGMENTS OF URINARY FIBRIN/FIBRINOGEN DEGRADATION PRODUCTS (FDP) AND INTRAGLOMERULAR FIBRIN/FIBRINOGEN RELATED ANTIGEN (FRA)松永, 健司renal diseasefibrin/fibrinogen degradation products (FDP)crosslinked fibrinIn children with several kinds of renal diseases, fragments of urinary fibrin/fibrinogen degradation products (FDP) and crosslinked fibrin degradation products (XLFbDP) were investigated by autoradiography using western blotting method. Results were compared with distribution and immunological features of intraglomerular fibrin/fibrinogen related antigen (FRA) based on immunohistopathologic method containing monochloroacetic acid (MCA) treatment. In patients with minimal change nephrotic syndrome or membranous nephropathy, crosslinked fibrin (XLFb) was not present in their glomeruli, and urinary FDP were composed of fibrinogen degradation products (FgDP) such as X, Y and D. On the other hand, in cases of proliferative glomerulonephritis such as Henoch-Schönlein
purpura nephritis or IgA nephropathy, XLFb was frequently observed along glomerular capillary walls. In these cases, urinary FDP were composed of XLFbDP (D-dimer) together
with FgDP. It was concluded that the presence of D-dimer in the urine suggested intraglomerular XLFb, but some part of urinary FDP, especially FgDP, were derived from plasma fibrinogen or FDP.奈良医学会2012-01-23T08:08:09Z2012-01-23T08:08:09Z1992-06-30ArticleDepartmental Bulletin Paper1007026 bytesapplication/pdf奈良医学雑誌 Vol.43 No.3 p.213-2210469555013450069http://hdl.handle.net/10564/190504695550AN00180974奈良医学雑誌433213221jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/19062017-05-29T06:07:51Zhdl_10564_1899IgA腎症とループス腎炎におけるトロンボモジュリン,プロテインC,プロテインCインヒビターの血中・尿中動態およびトロンボモジュリンの糸球体内局在PLASMA AND URINARY LEVELS OF THROMBOMODULIN, PROTEIN C, PROTEIN C INHIBITOR AND INTRAGLOMERULAR LOCALIZATION OF THROMBOMODULIN IN PATIENTS WITH IGA NEPHROPATHY AND LUPUS NEPHRITIS榎本, 康博IgA nephropathylupus nephritisprotein Cprotein C inhibitorthrombomodulinThe author investigated plasma and urinary levels of thrombomodulin (TM) antigen, protein C (PC) antigen, protein C inhibitor (PCI) activity and intraglomerular localization of TM antigen in IgA nephropathy (IgA-GN) and in lupus nephritis (LN). The subjects enrolled in this study were 40 patients with IgA-GN, 20 patients with LN and 19 healthy volunteers as controls. Plasma and urinary levels of TM and PC antigen were measured by sandwich enzyme immunoassay. Plasma and urinary levels of PCI activity were expressed as inhibition activity for activated PC. Intraglomerular localization of TM antigen was detected by immunohistochemical methods using a polyclonal antibody for human TM.
Plasma TM levels in the advanced stage of IgA-GN and in diffuse proliferative LN were significantly higher than those in controls. On the contrary, urinary TM levels in the
advanced stage of IgA-GN and in mesangial LN were significantly lower than those in controls. In IgA-GN there were significant positive correlations between the grade of
mesangial proliferation and plasma levels of TM, PC or PCI. As for intraglomerular localization of TM, in IgA-GN the staining intensity of TM on endothelial cells of
glomerular tufts was decreased according to mesangial proliferation. The staining intensity of TM was higher in mesangial LN than in diffuse proliferative LN. These findings suggest that plasma TM, PC and PCI may be involved in progression of IgA-GN and that intraglomerular TM localization is influenced by the severity of glomerular lesions in IgA-GN as well as LN.奈良医学会2012-01-24T02:24:03Z2012-01-24T02:24:03Z1992-06-30ArticleDepartmental Bulletin Paper1485265 bytesapplication/pdf奈良医学雑誌 Vol.43 No.3 p.222-2330469555013450069http://hdl.handle.net/10564/190604695550AN00180974奈良医学雑誌433222233jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/19072017-05-29T06:07:52Zhdl_10564_1899術式別にみた胃切除術後骨代謝障害に関する研究EFFECT OF SURGICAL PROCEDURES ON METABOLIC BONE DISEASE AFTER GASTRECTOMY奥村, 徹渡辺, 明彦澤田, 秀智中野, 博重中谷, 勝紀metabolic bone disease after gastrectomymicrodensitometrypylorus preserving gastrectomy pylorus preserving nearly total gastrectomyTo study the effect of surgical procedures on metabolic bone disease (MBD) after gastrectomy, the incidence of MBD was examined with Microdensitometry in 210 gastrectomized patients. In 97 (46.2%) of 210 patients MBD was found. The incidence
in female patients was significantly higher than in males (p<0.01). The incidence did not
correlate with the length of time after gastrectomy, age group or primary diseases. In relation to extent of gastrectomy, MBD in patients with total gastrectomy was significantly higher than in those with distal gastrectomy (p<0.05). In relation to reconstructive procedures, MBD in patients with pylorus preserving gastrectomy (PPG) was significantly lower than in those with Birrloth-Ⅰ (B-Ⅰ) or Birrloth-Ⅱ (B-Ⅱ) (p<0.05) ; MBD in patients with pylorus preserving nearly total gastrectomy (PPNTG) was significantly lower than in those with Roux-en-Y (R-Y) or interposition (I.P) (p<0.05). The level of serum alkalinephosphatase in patients with PPG was significantly lower than the level in those with B-Ⅰ or B-Ⅱ (p<0.01). The level of serum calcium in patients with PPNTG was significantly higher than level in those with R-Y or I. P (p<0.05). The calcitonin level in patients with total gastrectomy was significantly higher than the level in patients with distal gastrectomy or subtotal gastrectomy (p<0.05). This study reveals that the incidence was low in the procedure involving a small extent of gastric resection and in reconstructive procedures with pyloric preservation, such as pylorus preserving gastrectomy or pylorus preserving
nearly total gastrectomy. It is concluded that metabolic bone disease after gastrectomy is attributable to physical and chemical decrease in digestive and absorptional function influenced by gastrectomy.奈良医学会2012-01-24T08:49:21Z2012-01-24T08:49:21Z1992-06-30ArticleDepartmental Bulletin Paper1274315 bytesapplication/pdf奈良医学雑誌 Vol.43 No.3 p.234-2460469555013450069http://hdl.handle.net/10564/190704695550AN00180974奈良医学雑誌433234246jpnpublisher