2024-03-29T06:26:52Zhttp://ginmu.naramed-u.ac.jp/dspace-oai/request
oai:ginmu.naramed-u.ac.jp:10564/422017-05-29T06:07:17Zhdl_10564_1547表紙、目次、投稿規程、奥付(Vol.53 No.1)表紙目次投稿規程奥付奈良医学会奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.53 No.1http://ginmu.naramed-u.ac.jp/dspace/handle/10564/42Journal of Nara Medical Association, 53(1)http://hdl.handle.net/10564/42http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/42/1/00p.%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5312002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/432017-05-29T06:09:27Zhdl_10564_1547大腸癌転移における腫瘍宿主相互関係TUMOR-HOST RELATIONSHIP IN COLON CANCER METASTASIS國安, 弘基colon cancermouse Orthotopic cancer modelmucosal hyperplasia,metastasis癌とその周囲の宿主組織との微小環境における相互作用は癌の発生・進展さらには転移に大きな影響を与える因子であり,その解明は,癌の機構解明に重要であるのみならず,診断・治療への応用が期待される。癌細胞が産生・分泌する多種多様の因子が腫瘍に接する正常組織に影響を与えるが,その点では,痛周囲の正常組織は痛の総合的な性質を測る一つの試験紙ということができる。マウスを用いた同所性移植大腸癌モデルは移植痛組織に対する宿主組織の純粋な反応性変化を評価するのに適した系であり,同実験系とヒト大腸癌組織に対して検討を行い,痛一宿主相互作用を通じた転移促進機序の解明を行った。われわれは,ヌードマウス盲腸にヒト大腸癌細胞株を移植し痛周囲粘膜の変化を検討した。痛移植後癌周囲粘膜には過形成性形態変化が発生しproliferating cell nuclear antigen(PCNA)陽性核の増加を伴っている。この変化に伴い,過形成性粘膜からのvascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)といった血管新生因子の発現が克進し,癌と粘膜との境界部に多数の新生血管が形成される。また,epigeneticな変化に起因するmutL homologl(MLHl),O6-methylguanine-DNA methyltransferase(MGMT),p16INK4AといったDNA修復遺伝子・細胞周期抑制因子の発現低下が認められる。これらの変化の一因として,癌細胞から産生されるinterleukin(IL)-15が重視される.このような,動物モデルにより明らかとなった知見は,ヒト大腸癌手術材料でも確認され,癌周囲粘膜の過形成性変化は血管新生を通じて癌の進展・転移を促進するのみならず,転移能を反映するマーカーでもあることが示された。この結果をもとに,ヒト大腸癌術前内視鏡的生検材料を用いて痛周囲粘膜上皮におけるKi-67 1abeling indexを指標として切除後の転移の有無をprospectiveに予測検討した.この結果,転移陽性症例では癌周囲粘膜の過形成性変化Ki-671abelingindexは有意に非転移例よりも高く,80%の症例で転移の有無を正診し得た。このように,痛周囲粘膜は痛の進展に重要であり,生検により転移マーカーとしても有用と考えられた。奈良医学会奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.1-913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/43Journal of Nara Medical Association, 53(1): 1-9http://hdl.handle.net/10564/43http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/43/1/01-09p.%e5%a4%a7%e8%85%b8%e7%99%8c%e8%bb%a2%e7%a7%bb%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e8%85%ab%e7%98%8d%e5%ae%bf%e4%b8%bb%e7%9b%b8%e4%ba%92%e9%96%a2%e4%bf%82%ef%bc%88%e5%9c%8b%e5%ae%89%e5%bc%98%e5%9f%ba%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association531192002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/442017-05-29T06:09:27Zhdl_10564_1547糖尿病性腎症治療のエビデンスDIABIETIC NEPHROPATHY AND EVIDENCE-BASED MEDICINE金内, 雅夫angiotensin-converting enzyme inhibitorantihypertensive therapydiabetic nephropathyevidence-based medicine糖尿病性腎症治療の3本柱は,血糖管理,降庄療法ならびに蛋白制限食といわれている。とくに,血糖管理と降庄療法の有効性は,1990年代の後半から大規模臨床試験に基づくエビデンスの集積が著しい。また,正常血圧例に対するアンジオテンシン変換酵素阻害薬の腎保護作用も注目されている。さらに最近,アンジオテンシンーⅡ受容体遮断薬の治療効果が確認され,糖尿病性腎症の治療は新たな進歩を遂げつつある。本総説では,糖尿病性腎症治療の最新のエビデンスを紹介する。奈良医学会奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.11-1713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/44Journal of Nara Medical Association, 53(1): 11-17http://hdl.handle.net/10564/44http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/44/1/11-17p.%e7%b3%96%e5%b0%bf%e7%97%85%e6%80%a7%e8%85%8e%e7%97%87%e6%b2%bb%e7%99%82%e3%81%ae%e3%82%a8%e3%83%93%e3%83%87%e3%83%b3%e3%82%b9%ef%bc%88%e9%87%91%e5%86%85%e9%9b%85%e5%a4%ab%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association53111172002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/572017-06-11T23:20:26Zhdl_10564_1547Procaspases and Apoptotic Protease-Activating Factor-1(APAF-1) in Bovine Thymus, Brain, and Liver Partial Purification and Tissue DistributionItaya-Hironaka, AsakoapoptosisApaf-1procaspasebovinethymusbrainliverWe fractionated and highly purified a terminal pro-DEVDase, procaspase 9, and Apafï¼ 1from bovine thymus extracts by three steps of column Chromatography. Using the purified factors, the essential factors of the mitochondriamediated(typeII) apoptotic pathway, we constructed a supplementation assay for each factor to examine the distribution in bovine thymus, brain, andliver. All the tissues expressed a class of procaspase 9 with a molecular size of 50 kDa. The distribution of proDEVDase, however, varied in the tissues. The chromatography of proDEVDase
revealed the presence of four peaks in thymus, three in liver, and one in brain extracts. Among them, two major thymus proDEVDase(BT-prODEVDase-1 and-2) and a brain proDEVDase(BB-proDEVDase) were further purified. Although they were
procaspase 3-1ike judging from the substrate specificity and reactivity with anti-human caspase 3 antibody, they were slgnificantly different from each otherin molecular size and in reactivity with anti-human caspase 7, Suggesting that they are different molecular species. All of these results revealed a diversity of tissue-specific expression proDEVDase. Among the three factors examined, tissue distribution of Apaf-1 showed the most distinctive feature. The brain extracts showed essentially no caspase activation when incubated with cytochrome c and dATP but restored the activity when purified
thymus Apaf-1 was supplemented. Essentially no Apaf-1 activity was detected in the
extracts of bovine brain, suggesting that mature bovine brain lacks type II apoptotic
pathway in spite of the essential role in the programmed cell death during the normal
development of the brain tissue. Biological significance of these findings will be discussed.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.19-3513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/57Journal of Nara Medical Association, 53(1): 19-35http://hdl.handle.net/10564/57http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/57/1/19-35p.Procaspases_and_Apoptotic_Protease-Activating_Factor-1%28APAF-1%29_in_Bovine_Thymus%2c_Brain%2c_and_Liver_Partial_Purification_and_Tissue_Distribution%28Asako_ITAYA-HIRONAKA%29.pdf13450069AA11252383Journal of Nara Medical Association53119352002-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/582017-06-11T23:20:26Zhdl_10564_1547軸索切断後の迷走神経核および舌下神経核の神経細胞とグリア細胞におけるp38 MAP kinaseの発現EXPRESSION OF p38 MITOGEN-ACTIVATED PROTEIN(MAP) KINASE IN THE NEURONS AND THE GLIAL CELLS OF THE DORSAL MOTOR NUCLEUS OF THE VAGUS NERVE AND THE HYPOGLOSSAL NUCLEUS AFTER AXOTOMY下川原, 立山田, 英二桝井, 勝也榎本, 泰典井上, 和也市島, 國雄axotomyp38 mitogen-activated protein kinasevagus nervehypoglossal nervein situ hybridizationMitogen-activated protein (MAP) kinase cascades are activated in response to various extracellular stimuli. p38 MAP kinase is one of the MAP kinase family and is activated in response to various extracellular stimuli such as proinflammatory cytokines and environmental stresses. To obtain information about the role of the p38 MAP kinase in the neurons and the glial cells after axotomy, we nvestigated changes of p38 MAP kinase expression in the dorsal motor nucleus(DMN) of the vagus nerve and the hypoglossal nucleus after axotomy in adult rats using in situ hybridization and immunohistochemical techniques. Expression of p38 MAP kinase mRNA was observed in the cytoplasms of the neurons in control rats, and showed no marked changes after axotomy. Three days after axotomy, however, expression of p38 MAP kinase mRNA was observed in the cytoplasms of perineuronal microglias in both nuclei. Immunohistochemical analysis revealed expression of p38 MAP kinase in the
cytoplasms and nuclei of neurons in both nuclei in control rats. The stronger expression
of activated p38 MAP kinase was observed in the DMN ofthe vagus nerve than in the hypoglossal nucleus. After axotomy,the expression of p38 MAP kinase, inactive and active, was reduced in the nuclei of neurons in both nuclei, while perineuronal microglias showed increased expression in their cytoplasms and nuclei. These findings indicate that the reduction of the expression of p38 MAP kinase, inactive and active, influences the transcription factors, and plays an important role in retrograde neuronal reactions. Moreover, the increased expression of p38 MAP kinase in the perineuronal microglias may be related to microglial cell reactions and retrograde neuronal reactions.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.37-4513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/58Journal of Nara Medical Association, 53(1): 37-45http://hdl.handle.net/10564/58http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/58/1/37-45p.%e8%bb%b8%e7%b4%a2%e5%88%87%e6%96%ad%e5%be%8c%e3%81%ae%e8%bf%b7%e8%b5%b0%e7%a5%9e%e7%b5%8c%e6%a0%b8%e3%81%8a%e3%82%88%e3%81%b3%e8%88%8c%e4%b8%8b%e7%a5%9e%e7%b5%8c%e6%a0%b8%e3%81%ae%e7%a5%9e%e7%b5%8c%e7%b4%b0%e8%83%9e%e3%81%a8%e3%82%b0%e3%83%aa%e3%82%a2%e7%b4%b0%e8%83%9e%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8bp38_MAP_kinase%e3%81%ae%e7%99%ba%e7%8f%be%ef%bc%88%e4%b8%8b%e5%b7%9d%e5%8e%9f%e7%ab%8b%e3%80%80%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association53137452002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/592017-05-29T06:07:17Zhdl_10564_1547冷凍保存骨髄細胞を用いた培養骨移植による骨形成能の評価EVALUATION OF OSTEOGENIC CAPACITY OF CUIJURED BONE GRAFT USING CRYOPRESERVED MARROW CELLS中島, 弘司吉川, 隆幸市島, 囲雄山田, 英二井上, 和也榎本, 泰典大串, 始高倉, 義典土肥, 祥子cryopreservationmarrowhydroxyapatiteosteoblastosteogenesisTo investigate the osteogenic capacity of cryopreserved marrow cells, rat bone marrow cells obtained from femora were culturedin a standard medium for ten days. The cultured cells were released by trypsin treatment and stored at -196-C (liquid nitrogen) in a preservative culture medium containing lO% dimethylsulfoxide. After 3 months, the cryopreserved cells were thawed and subcultured in porous hydroxyapatite (HA; Interpore500). The medium consisted of Eagle-MEM containing 15% fetal bovine serum, antibiotics, ascorbic acid, b-glycerophosphate and dexamethasone. After 2 weeks of the subculture, the composites of the cells and porous HA were subcutaneously implanted into syngeneic rats. These implants were harveSted 2 and 4 weeks postimplantation and prepared for histological, biochemical and gene expression analyses. These implants showed bone formation together with active osteoblasts in many pore regions. Northern hybridization showed osteoblast marker of alkaline phosphatase (ALP) and osteocalcin in cryopreserved marrow cells. The course of ALP activities and amounts of osteocalcin derived ftom cryopreserved marrow cells were comparable to those derived from fresh marrow cells. These results indicate the osteogenic capacity of cryopreserved marrow cells in porous HA.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.47-5313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/59Journal of Nara Medical Association, 53(1): 47-53http://hdl.handle.net/10564/59http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/59/1/47-53p.%e5%86%b7%e5%87%8d%e4%bf%9d%e5%ad%98%e9%aa%a8%e9%ab%84%e7%b4%b0%e8%83%9e%e3%82%92%e7%94%a8%e3%81%84%e3%81%9f%e5%9f%b9%e9%a4%8a%e9%aa%a8%e7%a7%bb%e6%a4%8d%e3%81%ab%e3%82%88%e3%82%8b%e9%aa%a8%e5%bd%a2%e6%88%90%e8%83%bd%e3%81%ae%e8%a9%95%e4%be%a1%ef%bc%88%e4%b8%ad%e5%b3%b6%e5%bc%98%e5%8f%b8%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association53147532002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/602017-06-11T23:20:26Zhdl_10564_1547A Case of Pleuroperitoneal Communication in Continuous Ambulatory Peritoneal DialysisMatsumura, NorihikoKikawa, TadatoshiHanatani, MasakazuNonaka, Hideopleuroperitoneal communicationhydrothoraxintra-abdominal pressurecontinuous ambulatory peritoneal dialysisWe present a patient who developed a massive right-Sided hydrothorax two months after starting CAPD treatment, a 41-year-old female with IgA nephropathy who was followed up at our outpatient clinic. Due to deteriorating renal function, a peritoneal catheter was inserted on March 29, 1997.CAPD was implemented on the same day. At the time when CAPD was initiated, the patient was experienclng repeated episodes of nausea and vomiting, probably due to uremia. On May 27, she developed dyspnea. A chest X-ray Showed massive right-Sided hydrothorax. After extracorporeal ultrafiltration was performed, the patient's respiratory distress was rapidly relieved. Two days later, CAPD was esumed, but this resulted in almost immediate recurrence of massive right-sided hydrothorax. The property of the drained fluid from the right pleural cavity and scintigraphy uslng Technetium-99m macroaggregated albumin
confirmed pleuroperitoneal communication. Increased intra-abdominal pressure due to frequent vomiting may be responsible for hydrothorax due to pleuroperitoneal communication.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.55-5913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/60Journal of Nara Medical Association, 53(1): 55-59http://hdl.handle.net/10564/60http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/60/1/55-59p.A_Case_of_Pleuroperitoneal_Communication_in_Continuous_Ambulatory_Peritoneal_Dialysis%28Norihiko_MATSUMURA_..._et_al.%29.pdf13450069AA11252383Journal of Nara Medical Association53155592002-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/612017-05-29T06:09:27Zhdl_10564_1547原発性アルドステロン症に甲状腺乳頭癌を合併した1例A CASE OF PRIMARY ALDOSTERONISM ASSOCIATED WITH PAPILLARY CARCINOMA OF THE THYROID辻本, 達寛飯岡, 弘伊浪崎, 正豊川, 泰勲上野, 貴久美鶴薗, 卓也松村, 吉庸永吉, 純一黒岡, 公雄岩井, 哲郎小橋, 和雄岡本, 新悟福井, 博prlmary aldosteronismpapillary carcinomaMENA44-year-old man with primary aldosteronism associated with papillary carcinoma of the
thyroid is presented. He was admitted to our hospital for further evaluation of periodic paralysis, hypokalemia and hypertension. Laboratory data revealed low plasma renin activity, and elevated plasma aldosterone concentration. These dataindicated that the patient had prlmary aldosteronism. Ultrasonography, dynamic-CT and magnetic resonanceimaging demonstrated the existence of a hypovascular tumor in the right adrenal gland. During further examination, a Calcified tumor was found in his neck and diagnosed as thyroid carcinoma. The adrenal tumor was removed and its histologlCal diagnosis was aldosterone producing adenoma.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.61-6713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/61Journal of Nara Medical Association, 53(1): 61-67http://hdl.handle.net/10564/61http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/61/1/61-67p.%e5%8e%9f%e7%99%ba%e6%80%a7%e3%82%a2%e3%83%ab%e3%83%89%e3%82%b9%e3%83%86%e3%83%ad%e3%83%b3%e7%97%87%e3%81%ab%e7%94%b2%e7%8a%b6%e8%85%ba%e4%b9%b3%e9%a0%ad%e7%99%8c%e3%82%92%e5%90%88%e4%bd%b5%e3%81%97%e3%81%9f1%e4%be%8b%ef%bc%88%e8%be%bb%e6%9c%ac%e9%81%94%e5%af%9b%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association53161672002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/622017-06-11T23:20:26Zhdl_10564_1547An Autopsy Case of Overwhelming Sepsis with Hypoglycemia in a Patient with Alcoholic Liver CirrhosisMatsumura, NorihikoSaitoh, NaotoshiYamaguchi, So-ichiKikawa, TadatoshiHanatani, MasakazuNonaka, HideohypoglycemiaSepsisalcoholic liver cirrhosisdisseminated intravascular coagulationmicroabscessA 46-year-old man, unconscious, was admitted to our hospitalas an emergency case. He was known to have liver disease due to excessive alcohol intake. He had fallen while riding a motorcycle one week before admission. On arrival, he was comatose and in a state of shock. Petechiae and subcutaneous bleeding were observed on his trunk and extremities. His left upper and lower extremities were remarkably swollen, and a discolored, elevated, hard mass was found on the outer side of the left ankle joint. He was diagnosed as having disseminated intravascular coagulation complicated by renal and liver failure. Hypoglycemia(plasma glucose level 29 mg/dl), hyperammonemia and severe metabolic acidosis were found. He was treated with controlled ventilation,
plasma expanders, blood transfusion, antibiotics, dopamine, noradrenaline,
nafamostate gabexate and hypertonic glucose. Despite this intensive treatment, he died of irreversible shock 20 hours after admission. Postmortem examination revealed small vegetation in the aortic Valve and microabscesses in the kidney, heart, thyroid gland, and retroperitoneal adipose tissues. These findings suggest that he had developed sepsis stemming from cellulitis further to alcoholic liver cirrhosis. It is considered imperative that physicians consider the possibility of hypoglycemia in all patients with multiorgan failure.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.69-7313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/62Journal of Nara Medical Association, 53(1): 69-73http://hdl.handle.net/10564/62http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/62/1/69-73p.An_Autopsy_Case_of_Overwhelming_Sepsis_with_Hypoglycemia_in_a_Patient_with_Alcoholic_Liver_Cirrhosis%28Norihiko_MATSUMURA_..._et_al.%29.pdf13450069AA11252383Journal of Nara Medical Association53169732002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/632017-05-29T06:09:25Zhdl_10564_1550表紙、目次、投稿規程、奥付(Vol.53 No.2)表紙目次投稿規定奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.53 No.213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/63Journal of Nara Medical Association, 53(2)http://hdl.handle.net/10564/63http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/63/1/000p.%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5322002-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/642017-05-29T06:09:26Zhdl_10564_1550ヒト免疫不全ウイルス(HIV)やその他のレトロウイルスの増殖機構におけるポリADPリボース合成酵素の役割THE ROLES OF POLY(ADP-RIBOSE) POLYMERASE IN THE REPLICATION OF HUMAN IMMUNODEFICIENCY VIRUS(HIV) AND OTHER RETROVIRUSES亀岡, 正典AIDSHIVPARPpoly(ADP-ribosyl)ationretrovirusAIDSの原因ウイルスであるヒト免疫不全ウイルス(HIV)やその他のレトロウイルスの生活環の複数の増殖ステップに,ポリADPリボース合成酵素(PARP)が制御因子として関わっている。その制御機構を明らかにすることは,新たなAIDS治療薬を開発する手がかりとなりうるものである。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.2 p.91-9913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/64Journal of Nara Medical Association, 53(2): 91-99http://hdl.handle.net/10564/64http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/64/1/091-099p.%e3%83%92%e3%83%88%e5%85%8d%e7%96%ab%e4%b8%8d%e5%85%a8%e3%82%a6%e3%82%a4%e3%83%ab%e3%82%b9%28HIV%29%e3%82%84%e3%81%9d%e3%81%ae%e4%bb%96%e3%81%ae%e3%83%ac%e3%83%88%e3%83%ad%e3%82%a6%e3%82%a4%e3%83%ab%e3%82%b9%e3%81%ae%e5%a2%97%e6%ae%96%e6%a9%9f%e6%a7%8b%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e3%83%9d%e3%83%aaADP%e3%83%aa%e3%83%9c%e3%83%bc%e3%82%b9%e5%90%88%e6%88%90%e9%85%b5%e7%b4%a0%e3%81%ae%e5%bd%b9%e5%89%b2%ef%bc%88%e4%ba%80%e5%b2%a1%e6%ad%a3%e5%85%b8%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association53291992002-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/652017-05-29T06:07:17Zhdl_10564_1547肺高血圧を伴う心房中欠損症に急性心筋梗塞を合併した高齢者の1例A CASE OF ATRIAL SEPTAL DEFECT WITH PULMONARY HYPERTENSION COMPLICATED WITH ACUTE MYOCARDIAL INFARCTION吉村, 充代中嶋, 美鐘渡邉, 眞言福島, 猛藤井, 厚史西田, 育功花谷, 正和野中, 秀郎長阪, 重雄関, 寿夫atrial septal defectacutemy ocardial infarctionpulmonary hypertensionWe describe a patient with pulmonary hypertension associated with an atrial septal defect (ASD) who suffered an acute myocardial infarction. The patient, 70-year-old man, was admitted to our hospital after developing chest pain. He had een diagnosed as having an ASD at the age of 69. From the electrocardiogram obtainedon admission, acute myocardial infarction was suspected. Coronary anglography revealed total obstruction of the left anterior descending coronary artery, which was successfully treated by percutaneous transluminal coronary angioplasty(PTCA). Because of repeated heart failure, ASD closure and
coronary artery bypass grafting (CABG) were performed in a one-stage operation. After
surgery, cardiac function improved. Direct PTCA in the acute phase and ASD closure and CABG in the chronic phase were effective for heart failure in this patient.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.75-8113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/65Journal of Nara Medical Association, 53(1): 75-81http://hdl.handle.net/10564/65http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/65/1/075-081p.%e8%82%ba%e9%ab%98%e8%a1%80%e5%9c%a7%e3%82%92%e4%bc%b4%e3%81%86%e5%bf%83%e6%88%bf%e4%b8%ad%e6%ac%a0%e6%90%8d%e7%97%87%e3%81%ab%e6%80%a5%e6%80%a7%e5%bf%83%e7%ad%8b%e6%a2%97%e5%a1%9e%e3%82%92%e5%90%88%e4%bd%b5%e3%81%97%e3%81%9f%e9%ab%98%e9%bd%a2%e8%80%85%e3%81%ae1%e4%be%8b%ef%bc%88%e5%90%89%e6%9d%91%e5%85%85%e4%bb%a3%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association53175812002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/662017-05-29T06:07:08Zhdl_10564_1547SPECTにて一過性全般性脳血流低下を示した非ヘルペス性ウイルス性脳症の1症例A CASE OF NON-HERPES VIRAL ENCEPHALOPATHY WITH A TRANSIENT DIFFUSE DECREASE IN CEREBRAL BLOOD FLOW
ON BRAIN SPECT DURING ANTIVIRAL THERAPY山内, 孝之森川, 将行洪, 基朝井上, 雄一朗大澤, 弘吉岸本, 年史飯田, 順三non-herpes viral encephalopathySequela99mTc-ECD brain SPECTdecreased cerebral blood flowElderly persons have a tendency to present with mental disorders such as delirium.
Environmental changes are known to induce mental disorders such as delirium in elderly
persons. At the time of acute mental sorder or impalrment, we need to take encephalitis or encephalopathy into consideration. In particular, evere encephalitis may cause sequelae such as dementia, personality change or disturbance of cerebral blood flow; these patients need to receive treatment at an early stage. We report a case of non-herpes viral encephalopathy
with a transient diffuse decrease in cerebral blood flow on brain SPECT during antiviral therapy. After the 72-year-old female had a tooth extracted, she gradually demonstrated psychiatric symptoms, which consisted of insomnia, delusion of persecution, delusion of observation and disorientation. Finally, she was complicated with disturbance of consciousness and admitted to our psychiatric ward. She was suspected of having encephalopathy, and treated mainly with acyclovir. She temporarily improved, but after a while her consciousness deteriorated again. Brain MRI showed normal findings, whereas brain SPECT (99mTc-ECD) showed a diffuse decrease in cerebral blood flow. Therefore, she was treated with oxygen inhalation and therapeutic agents which improved cerebral blood flow. As
result, she completely recovered and has had not any sequela such as dementia or
personality change. It was suggested that brain SPECT is useful to evaluate the pathology and decide the treatment for patients who demonstrate acute eterioration of consciousness during antiviral therapy.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.1 p.83-9013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/66Journal of Nara Medical Association, 53(1): 83-90http://hdl.handle.net/10564/66http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/66/1/083-090p.SPECT%e3%81%ab%e3%81%a6%e4%b8%80%e9%81%8e%e6%80%a7%e5%85%a8%e8%88%ac%e6%80%a7%e8%84%b3%e8%a1%80%e6%b5%81%e4%bd%8e%e4%b8%8b%e3%82%92%e7%a4%ba%e3%81%97%e3%81%9f%e9%9d%9e%e3%83%98%e3%83%ab%e3%83%9a%e3%82%b9%e6%80%a7%e3%82%a6%e3%82%a4%e3%83%ab%e3%82%b9%e6%80%a7%e8%84%b3%e7%97%87%e3%81%ae1%e7%97%87%e4%be%8b%ef%bc%88%e5%b1%b1%e5%86%85%e5%ad%9d%e4%b9%8b%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association53183902002-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/672017-05-29T06:07:08Zhdl_10564_1550原発性肺高血圧症の基礎と臨床BASIC AND CLINICAL ISSUES ON PRIMARY PULMONARY HYPERTENSION木村, 弘pulmonary hypertensionvascular remodelinggrowth factorprostacyclinlung transplantation原発性肺高血圧症(Primarypulmonaryhypertension;PPH)は,著しい前毛細血管性肺高血圧症のうち,肺高血圧症の基礎疾患となりうる心肺疾患がなく,原因が不明のものに与えられる臨床診断名である。本症の予後はきわめて不良で,確定診断からの中間生存率は3年以下で,5年生存率も40%前後である。1998年10月に臓器移植法が施行され,わが国においても移植医療が可能となったが,2002年1月の時点で,肺移植レシピエント待機症例41例中の25例がPPHとなっている。このことからも,PPHの重症度および社会的注目度がうかがえる。これまでの優れた基礎研究成果の積み重ねは臨床現場に還元され,PGI2静注薬による持続静注療法に発展した。現在では移植を待つ患者のつなぎ治療法として,その有用性が証明されている。難治性肺高血圧症の正しい診断方法の確立とともに,現状の治療限界を克服するためにも,遺
伝子治療の発展につながりうる病因・発症機序の究明が急がれる。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.2 p.101-11213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/67Journal of Nara Medical Association, 53(2): 101-112http://hdl.handle.net/10564/67http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/67/1/101-112p.%e5%8e%9f%e7%99%ba%e6%80%a7%e8%82%ba%e9%ab%98%e8%a1%80%e5%9c%a7%e7%97%87%e3%81%ae%e5%9f%ba%e7%a4%8e%e3%81%a8%e8%87%a8%e5%ba%8a%ef%bc%88%e6%9c%a8%e6%9d%91%e5%bc%98%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5321011122002-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/682017-05-29T06:09:27Zhdl_10564_1550HLA-E,-F,-Gの発現と機能 胎児・母体間免疫のブラックボックスは開きうるかEXPRESSION AND FUNCTION OF HLA-E,-F AND -G石谷, 昭子HLA-EHLA-FHLA-GplacentaimmunotoleranceいかなるHLA class IIもHLA-A,-Bも発現していない胎盤トロフォブラスト上には,多型性の乏しいHLA-E,-F,-Gが発現している。これらの分子の相互作用がどのように妊娠の維持に働いているかについて述べる。また最近,HLA-Gがアロ反応性T細胞のアポトージスを誘導する等の免疫寛容に係わっているという報告がでて,移植免疫の分野においても脚光を浴び始めている。これら分子の基礎と最新の知見について考察する。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.2 p.113-12313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/68Journal of Nara Medical Association, 53(2): 113-123http://hdl.handle.net/10564/68http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/68/1/113-123p.HLA-E%2c-F%2c-G%e3%81%ae%e7%99%ba%e7%8f%be%e3%81%a8%e6%a9%9f%e8%83%bd%e3%80%80%ef%bd%9e%e8%83%8e%e5%85%90%e3%83%bb%e6%af%8d%e4%bd%93%e9%96%93%e5%85%8d%e7%96%ab%e3%81%ae%e3%83%96%e3%83%a9%e3%83%83%e3%82%af%e3%83%9c%e3%83%83%e3%82%af%e3%82%b9%e3%81%af%e9%96%8b%e3%81%8d%e3%81%86%e3%82%8b%e3%81%8b%ef%bd%9e%ef%bc%88%e7%9f%b3%e8%b0%b7%e6%98%ad%e5%ad%90%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5321131232002-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/692017-05-29T06:09:27Zhdl_10564_1550くも膜のう胞の合併が疑われたパニック障害の1症例A CASE OF PANIC DISORDER WHERE A COMBINATION WITH ARACHNOID CYST WAS SUSPECTED武原, 弘典森川, 将行徳山, 明広金, 英浩洪, 基朝永野, 龍司岸本, 年史arachnoid cystpanic disorderArachnoid cyst is a benign tumor that is satisfied in cerebrosplnal fluid, and it arises in the subarachnoid cavity. Though it is often asymptOmatic, increased intracranial pressure and convulsive seizure may rarely be combined. We report a rare case of panic disorder where a combination with arachnoid cyst was suspected. The patient (a48-year-old female) was admitted to our psychiatric ward for the treatment of panic disorder. Arachnoid cyst in mega cisterna magna was indicated by brain MRI, and this was thought to be pressing on the cerebellum. She was treated with medication (alprazoram, setiptiline) and behavioral
therapy. As a result, her anxiety symptoms gradually improved. Since she had complained of morning headache during hospitalization, this headache might have been induced by the arachnoid cyst. The cyst might have affected panic disorder and careful observation is also required for the future.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.2 p.125-13113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/69Journal of Nara Medical Association, 53(2): 125-131http://hdl.handle.net/10564/69http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/69/1/125-131p.%e3%81%8f%e3%82%82%e8%86%9c%e3%81%ae%e3%81%86%e8%83%9e%e3%81%ae%e5%90%88%e4%bd%b5%e3%81%8c%e7%96%91%e3%82%8f%e3%82%8c%e3%81%9f%e3%83%91%e3%83%8b%e3%83%83%e3%82%af%e9%9a%9c%e5%ae%b3%e3%81%ae1%e7%97%87%e4%be%8b%ef%bc%88%e6%ad%a6%e5%8e%9f%e5%bc%98%e5%85%b8%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5321251312002-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/702017-05-29T06:09:27Zhdl_10564_1550発作後精神病状態を呈した1例A CASE OF POSTICTAL PSYCHOSIS IN COMPARISON WITH AIJERNATIVE PSYCHOSIS宮本, 敏雄川崎, 淳岸本, 年史epilepsypsychosispostictal psychosisalternative psychosisIn epilepsy various psychiatric symptoms occur, such as neurotic symptoms,mood disorder-like symptoms, and schizophrenia-like symptoms. The incidence of psychotic symptoms among epileptic patients is significantly higher than among the general population. Sengoku et al. reported the incidence of psychosis among epileptic patients to be 4.4%. Psychotic disorders associated with epilepsy are divided
into three groups: ictal psychosis, periictal psychosis, and interictal psychosis. Altemative psychosis and postictal psychosis are classified as acute periictal and interictal psychosis. We report a case of postictal psychosis and discuss the psychotic state, comparlng it with that of alternative psychosis. This postictal psychosis exhibited various features different from those of altemative psychosis, and many features of these
symptoms are similar to those described in other reports. Many studies suggest that
postictal psychoses and altemative psychoses have different features from case to case. Postictal psychoses often exhibit abnormally elevated mood and few schizophrenia-like symptoms such as Schneider's first-rank symptoms, whereas alternative psychoses often do exhibit Schneider's first-rank symptoms. This case showed typical features of postictal psychosis.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.2 p.133-13713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/70Journal of Nara Medical Association, 53(2): 133-137http://hdl.handle.net/10564/70http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/70/1/133-137p.%e7%99%ba%e4%bd%9c%e5%be%8c%e7%b2%be%e7%a5%9e%e7%97%85%e7%8a%b6%e6%85%8b%e3%82%92%e5%91%88%e3%81%97%e3%81%9f1%e4%be%8b%ef%bc%88%e5%ae%ae%e6%9c%ac%e6%95%8f%e9%9b%84%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5321331372002-04-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/712017-05-29T06:09:25Zhdl_10564_1551表紙、目次、投稿規程、奥付(Vol.53 No.3)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.53 No.313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/71Journal of Nara Medical Association, 53(3)http://hdl.handle.net/10564/71http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/71/1/000p.%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5332002-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/722017-05-29T06:09:25Zhdl_10564_1551心身医学の現状と最新の知見PRESENT CONDITION AND NEWEST KNOWLEDGE OF PSYCHOSOMATIC MEDICINE竹川, 隆山本, 浩笹田, 徹辻, 幸余野口, 隆一河口, 剛木地村, 麻衣子psychosomatic medicinebio-psycho-socio-ethical modeldiagnostic criteria of psycosomatic diseaseimmune-neuroendocrinologystress and gene心身症という概念には,心理社会的背景,性格要因,行動特性のように客観的には評価しにくい要素があるが,その点を踏まえ理解されるよう努力が進んでいる。また,医学の進歩により,心身相関の一部は解明されつつある。効率が最優先される今日,ますます全人的医療を実践しようとする心身医学の重要性,必要性が増している。心身症の診断,心身症の治療,死の臨床・緩和ケア,小児の心身症,ストレス・情動と神経・免疫・内分泌,心身症(ストレス)と遺伝子に分けて現状,最新の知見を紹介する。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.3 p.139-15113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/72Journal of Nara Medical Association, 53(3): 139-151http://hdl.handle.net/10564/72http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/72/1/139-151p.%e5%bf%83%e8%ba%ab%e5%8c%bb%e5%ad%a6%e3%81%ae%e7%8f%be%e7%8a%b6%e3%81%a8%e6%9c%80%e6%96%b0%e3%81%ae%e7%9f%a5%e8%a6%8b%ef%bc%88%e7%ab%b9%e5%b7%9d%e9%9a%86%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5331391512002-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/732017-05-29T06:06:57Zhdl_10564_1551小児心因性疾患の診断における量的視野検査の有用性IMPLICATION OF QUANTITATIVE VISUAL FIELD EXAMINATION IN CHILDHOOD PSYCHOSOMATIC DISEASES松永, 健司矢本, 陽子武山, 雅博今津, 美由紀visual fieldChildhoodpsychosomatic diseasehysteriapost traumatic stress disorder(PTSD)Therapeutic and diagnostic strategy for psychosomatic diseaseis an important issue for childhood health. Recently the incidence of childhood psychosomatic
diseases has been increaslng. The diagnosis of psychosomatic disease is usually based
on history and clinical symptoms, excluding organic diseases. The lack of methods
diagnosed objectively as having a psychosomatic disease might be responsible for difficulties in taking care of psychosomatic patients. It is known that tubular and/or spiral fields are seen in patients with psychosomatic visual disorder. We report herein three cases in which quantitative visual field examinations contribute to the diagnosis of psychosomatic diseases such as hysteria, post traumatic stress disorder (PTSD) and psychosomatic headache.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.3 p.153-15713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/73Journal of Nara Medical Association, 53(3): 153-157http://hdl.handle.net/10564/73http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/73/1/153-157p.%e5%b0%8f%e5%85%90%e5%bf%83%e5%9b%a0%e6%80%a7%e7%96%be%e6%82%a3%e3%81%ae%e8%a8%ba%e6%96%ad%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e9%87%8f%e7%9a%84%e8%a6%96%e9%87%8e%e6%a4%9c%e6%9f%bb%e3%81%ae%e6%9c%89%e7%94%a8%e6%80%a7%ef%bc%88%e6%9d%be%e6%b0%b8%e5%81%a5%e5%8f%b8%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5331531572002-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/742017-05-29T06:07:08Zhdl_10564_1551奈良県立医科大学術前術後麻酔科外来(麻酔相談外来)の現況THE CURRENT STATE OF THE ANESTHESIA CLINIC AT NARA MEDICAL UNIVERSITY HOSPITAL中橋, 一喜松成, 泰典岩田, 正人岩坪, 友美瓦口, 至孝井上, 聡己菊本, 克郎川口, 昌彦謝, 慶一北口, 勝康古家, 仁坂本, 尚典平井, 勝治呉原, 弘吉下川, 充anesthesia clinicsatisfaction with anesthesiapost-anesthetic complicationinformed consentSince its introduction in 1996, pre- and post-anesthetic consultation at the anesthesia clinic has been conducted for the surgical patients in Nara Medical University Hospital. Then, we evaluated many information obtained from those patients. Regarding pre-anesthetic problems, 39.2% of patients had anesthesia-related complications such as indication of ICU, taking anticoagulant agents, having cardiac complications, etc. Only 55.4% of patients visited with their families. Eighty-five percent of patients visited the anesthesia clinic after their operation. Additionally, we retrospectively evaluated post-anesthetic complications and satisfaction under general, epidural and splnal anesthesia from 1999 to 2001. Patients with dissatisfaction on splnal anesthesia were of a higher incidence than those on general anesthesia. The common undesirable complications in every anesthetic method were post-operative pain and nausea/vomiting. We concluded that explanations of anesthesia at pre- and post-anesthesia clinic were useful methods for anesthesia patients.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.3 p.159-16313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/74Journal of Nara Medical Association, 53(3): 159-163http://hdl.handle.net/10564/74http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/74/1/159-163p.%e5%a5%88%e8%89%af%e7%9c%8c%e7%ab%8b%e5%8c%bb%e7%a7%91%e5%a4%a7%e5%ad%a6%e8%a1%93%e5%89%8d%e8%a1%93%e5%be%8c%e9%ba%bb%e9%85%94%e7%a7%91%e5%a4%96%e6%9d%a5%ef%bc%88%e9%ba%bb%e9%85%94%e7%9b%b8%e8%ab%87%e5%a4%96%e6%9d%a5%ef%bc%89%e3%81%ae%e7%8f%be%e6%b3%81%ef%bc%88%e4%b8%ad%e6%a9%8b%e4%b8%80%e5%96%9c%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5331591632002-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/752017-05-29T06:06:57Zhdl_10564_1551超音波検査にて経過を観察しえたクローン病の1例ULTRASONOGRAPHIC FINDINGS OF CROHN'S DISEASE辻本, 達寛石川, 昌利飯岡, 弘伊浪崎, 正豊川, 泰勲鶴薗, 卓也松村, 吉庸兵藤, 公一本田, 伸行森田, 博高宮, 晋一福井, 博Crohn's diseaseultrasonographycontrast enhancementbowel wallGray-scale and color Doppler ultrasonography have been shown to be useful for examinlng patients with a variety of bowel diseases. We present here a case of a 27-year-old man with Crohn's disease who was examined trasonographically during the courseoftreatment. Gray-scale ultrasonography revealed marked thickening of the bowel wall, specifically thickening
of all the layers. Contrast-enhanced power Doppler US showed hypervascularity of all the layers. With effective treatment, thickening and hypervascularity of the bowel wall disappeared promptly. We conclude that information provided by ultrasonography is useful not only for detecting the bowel abnormality of Crohn's disease but also for evaluating the therapeutic effect on Crohn's disease, and that explanations of anesthesia at pre- and post-anesthetic clinic were useful methods for anesthetic patients.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.3 p.165-17213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/75Journal of Nara Medical Association, 53(3): 165-172http://hdl.handle.net/10564/75http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/75/1/165-172p.%e8%b6%85%e9%9f%b3%e6%b3%a2%e6%a4%9c%e6%9f%bb%e3%81%ab%e3%81%a6%e7%b5%8c%e9%81%8e%e3%82%92%e8%a6%b3%e5%af%9f%e3%81%97%e3%81%88%e3%81%9f%e3%82%af%e3%83%ad%e3%83%bc%e3%83%b3%e7%97%85%e3%81%ae1%e4%be%8b%ef%bc%88%e8%be%bb%e6%9c%ac%e9%81%94%e5%af%9b%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5331651722002-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/762017-05-29T06:06:35Zhdl_10564_1552表紙、目次、投稿規程、奥付(Vol.53 No.4)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.53 No.413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/76Journal of Nara Medical Association, 53(4)http://hdl.handle.net/10564/76http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/76/1/000p.%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5342002-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/772017-06-11T23:20:26Zhdl_10564_1552Quantitation and Visualization of Ultraviolet Induced DNA Damage Using Specific AntibodiesMori, ToshioKobayashi, NobuhikoCyclobutane pyrimidine dimer(6-4) photoproductMonoclonal antibodyELISAImmunofluorescenceThe major types of DNA damage induced by sunlight in the skin are DNA photoproducts, such as cyclobutane pyrimidine dimers (CPDs), (6-4)photoproducts (6-4PPs) and Dewar isomers of 6-4PPs. A sensitive method for quantitating and visualizing each type of DNA photoproduct induced by biologically relevant doses of UV or sunlight is essential to characterize DNA photoproducts and their biologlcal effects. We have established monoclonal antibodies specific for CPDs, 6-4PPs or Dewar isomers. Those antibodies allow one to quantitate
photoproducts in DNA purified from cultured cells or from the skin epidermis uslng an
enzyme-linked immunosorbent assay. One can also use those specific antibodies with in situ laser cytometry to visualize and measure DNA photoproducts in cultured cells or in the skin, using indirect immunofluorescence and a laser-scannlng confocal microscope. This latter method allows us to reconstruct three-dimensional images of nuclei containlng DNA photoproducts, and to simultaneously examine DNA photoproducts and histology in multilayered epidermis. Using those techniques, one can determine the induction and repair of these three distinct types of DNA photoproducts in cultured cells and in the skin exposed to sublethal or suberythematous doses of UV or solar simulated radiation. As examples of the utility of these techniques and antibodies, we describe the DNA repalr kinetics followlng irradiation of human cell nuclei and the photoprotective effect of melanin against DNA photoproducts in cultured pigrlented cells and in human epidermis.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.4 p.179-19113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/77Journal of Nara Medical Association, 53(4): 179-191http://hdl.handle.net/10564/77http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/77/1/179-191p.Quantitation_and_Visualization_of_Ultraviolet_Induced_DNA_Damage_Using_Specific_Antibodies%28Toshio_MORI_..._et_al.%29.pdf13450069AA11252383Journal of Nara Medical Association5341791912002-08-31engpublisher
oai:ginmu.naramed-u.ac.jp:10564/782017-06-11T23:20:26Zhdl_10564_1551Hemorrhagic Arachnoid Cyst of the Posterior : A Case ReportMotoyama, YasushiSatow, TakeshiHiguchi, KazushiIsaka, FumiakiYamazoe, NaohiroNabeshima, Sachioarachnoid cystposterior fossahemorrhagehead injuryArachnoid cysts are reported to be occasionally associated with subdural
hematoma or hygroma. Spontaneous disappearances of arachnoid cysts have been
reported previously and in was emphasized that rupture of cyst membrane and subdural
hematoma or hygroma must be essential for them to disappear. We report herein a case
of hemorrhagic arachnoid cyst of the posterior fossa. The hemorrhagic cyst was not accompanied by subdural hematoma or hygroma and gradually reduced in size.
A 21-year-old man sustained a cerebral contusion and epidural hematoma of the
frontal reglon from a head injury. Computerized tomography scannlng obtained 12 hours after the inJury revealed a hemorrhagic retrocerebellar arachnoid cyst. Magnetic resonance imaging performed on day 21 revealed that the hemorrhagic arachnoid cyst had high intensity on a T1-weighted image and relatively low intensity on a T2-
weighted image without subdural hematoma or hygroma. Follow-up CT scans revealed
that the hemorrhagic arachnoid cyst had reduced in size. The patient made an almost
complete recovery and was discharged with no observable neurologlcal deficits three
months after admission.
Hemorrhage was not presentin the first few hours after head injury but developed
Subsequently, confined strictly to the cystic cavity. This case report provides evidence that disappearance or reduction of arachnoid cysts can occur without the need for subdural hematoma or effusion.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.3 p.173-17713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/78Journal of Nara Medical Association, 53(3): 173-177http://hdl.handle.net/10564/78http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/78/1/173-177p.Hemorrhagic_Arachnoid_Cyst_of_the_Posterior_A_Case_Report%28Yasushi_MOTOYAMA_..._et_al.%29.pdf13450069AA11252383Journal of Nara Medical Association5331731772002-06-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/792017-05-29T06:09:10Zhdl_10564_1552放射線医学の最近の進歩 画像診断からIVRRECENT PROGRESS OF RADIOLOGY ; IMAGING DIAGNOSIS AND IVR吉川, 公彦廣橋, 伸治中川, 裕之阪口, 浩radiologyimaging diagnosisinterventional radiology放射線医学の最近の進歩は目覚ましく,CT,MRIを中心とする種々の診断技術の発達により,画像診断は従来の形態的診断に加えて,臓器における血流変化あるいは機能的変化を可視化することができるようになり,各種疾患の早期発見と病態解明ならびに治療法の開発に大きく寄与している。一方,放射線診断技術の治療的応用であるインターベンショナルラジオロジー(IVR)は低侵襲的治療法として注目され,今後益々発展・普及すると考えられるが,IVRの適応決定,実施,効果判定には質の高い画像診断が要求されるため,放射線科医の果たす役割は極めて大きい。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.4 p.193-20013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/79Journal of Nara Medical Association, 53(4): 193-200http://hdl.handle.net/10564/79http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/79/1/193-200p.%e6%94%be%e5%b0%84%e7%b7%9a%e5%8c%bb%e5%ad%a6%e3%81%ae%e6%9c%80%e8%bf%91%e3%81%ae%e9%80%b2%e6%ad%a9%e3%80%80%e7%94%bb%e5%83%8f%e8%a8%ba%e6%96%ad%e3%81%8b%e3%82%89IVR%ef%bc%88%e5%90%89%e5%b7%9d%e5%85%ac%e5%bd%a6%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5341932002002-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/802017-05-29T06:07:08Zhdl_10564_1552奈良県立医科大学附属病院精神科における1999年度の入院・外来患者臨床統計NOSOLOGICAL DATA ON OUTPATIENTS AND INPATIENTS IN THE DEPARTMENT OF PSYCHIATRIC SERVICE AT NARA MEDICAL UNIVERSITY HOSPITAL IN FISCAL 1999池下, 克実森川, 将行洪, 基朝木内, 邦明岸田, 学岸野, 加苗中谷, 紀子橋本, 和典原田, 信治牧之段, 学吉岡, 玲吉村, 智恵米本, 重夫五十嵐, 潤小倉, 絵美子梶本, 隆哉高橋, 弘幸段野, 哲也中田, 正樹林, 竜也横山, 敬輝芳野, 浩樹徳山, 明広根来, 秀樹井上, 雄一郎平山, 智英法山, 良信大澤, 弘吉岸本, 年史ICD-10psychiatric servicenosologyNosologlcal data on outpatients and inpatients in the Psychiatric Service of
Nara Medical University Hospital in fiscal 1999, are reported in this paper. There were
967 outpatient cases and inpatients were 232 inpatient cases. According to the diagnostic classification using F codes of the ICD-10, F4 (neurotic, stress-related and somatoform disorder) was most frequent (255 cases, 27%) in the outpatients, followed by F3 (mood disorder; 221 cases, 23%), F0 (organic, including symptomatic, mental disorder; 135 cases, 14%) and others. On the other hand, F2 (schizophrenia schizotypal and delusional
disorder) was most frequent (69 cases, 30%) in the inpatients, followed by F4 (neurotic, stress-related and somatoform disorder; 51 cases, 22%), F3 (mood disorder; 38 cases, 16%) and others.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.4 p.201-20513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/80Journal of Nara Medical Association, 53(4): 201-205http://hdl.handle.net/10564/80http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/80/1/201-205p.%e5%a5%88%e8%89%af%e7%9c%8c%e7%ab%8b%e5%8c%bb%e7%a7%91%e5%a4%a7%e5%ad%a6%e9%99%84%e5%b1%9e%e7%97%85%e9%99%a2%e7%b2%be%e7%a5%9e%e7%a7%91%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b1999%e5%b9%b4%e5%ba%a6%e3%81%ae%e5%85%a5%e9%99%a2%e3%83%bb%e5%a4%96%e6%9d%a5%e6%82%a3%e8%80%85%e8%87%a8%e5%ba%8a%e7%b5%b1%e8%a8%88%ef%bc%88%e6%b1%a0%e4%b8%8b%e5%85%8b%e5%ae%9f%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5342012052002-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/812017-05-29T06:06:35Zhdl_10564_1552骨盤部CTにより術前診断しえた閉鎖孔ヘルニアの2例TWO CASES OF OBTURATOR HERNIA DIAGNOSED PREOPRATIVELY BY PELVIC COMPUTED TOMOGRAPHY浪崎, 正辻本, 達寛石川, 昌利飯岡, 弘伊豊川, 泰勲鶴薗, 卓也松村, 吉庸福井, 博obturator herniapelvic CTDiagnosis of obturator hernia before surgery is difficult, we report here
two patients who were uneventfully operated on after successful diagnosis by CT
scannlng of the pelvic cavity.
Case 1 : An eighty-one-year-old woman was admitted to our hospital because of left
lower abdominal paln. Abdominal X-ray film revealed of formation of niveau and
dilatation of the small intestine. CT scanning of the pelvic cavity revealed left obturator hernia.
Case 2 : An eighty-two-year-old woman was admitted to our hospital because of
vomiting and right lower abdominal paln. Abdominal X-ray film revealed formation of
niveau and dilatation of the small intestine. CT scanning of the pelvic cavity revealed right obturator hernia.
As shown in these cases, computed tomography is a useful tool for early diagnosis of cryptic cases of incomplete small bowel obstruction. It is concluded that CT scanning of the pelvic cavity should be performed in elderly and thin patients with ileus of unknown etiology.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.4 p.207-21213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/81Journal of Nara Medical Association, 53(4): 207-212http://hdl.handle.net/10564/81http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/81/1/207-212p.%e9%aa%a8%e7%9b%a4%e9%83%a8CT%e3%81%ab%e3%82%88%e3%82%8a%e8%a1%93%e5%89%8d%e8%a8%ba%e6%96%ad%e3%81%97%e3%81%88%e3%81%9f%e9%96%89%e9%8e%96%e5%ad%94%e3%83%98%e3%83%ab%e3%83%8b%e3%82%a2%e3%81%ae2%e4%be%8b%ef%bc%88%e6%b5%aa%e5%b4%8e%e6%ad%a3%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5342072122002-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/822017-05-29T06:06:34Zhdl_10564_1553表紙、目次、総目次、投稿規程詳細、奥付(Vol.53 No.5-6)表紙目次総目次投稿規程詳細奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.53 No.5-613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/82Journal of Nara Medical Association, 53(5-6)http://hdl.handle.net/10564/82http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/82/1/000p.%e8%a1%a8%e7%b4%99%e3%80%81%e7%9b%ae%e6%ac%a1%e3%80%81%e7%b7%8f%e7%9b%ae%e6%ac%a1%e3%80%81%e6%8a%95%e7%a8%bf%e8%a6%8f%e7%a8%8b%e8%a9%b3%e7%b4%b0%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association535-62002-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/832017-05-29T06:09:39Zhdl_10564_1553口腔癌に対する化学・放射線併用療法と臓器・機能温存への応用CHEMORADIOTHERAPY AND ITS APPLICATION TO ORGAN-FUNCTION PRESERVATION FOR ORAL CANCER桐田, 忠昭oral cancerchemoradiotherapyorgan-function preservationhead and neck cancer口腔癌は大部分が扁平上皮癌により占められ,放射線治療に対し比較的感受性が高いため,早期症例には根治治療として放射線が選択される場合も多い。しかし,多くを占める進展症例に対しては,放射線単独での効果は期待できず,また,neoadjuvant chemotherapy(NAC)を代表とされる化学療法も予後の改善までには至っていない。しかし,両者の併用によって,少量の照射線量で著明な腫瘍縮小効果が認められ,より高い局所制御が得られたり,低い線量時点での効果判定で局所制御や予後がある程度予測でき,治療法の変更が可能になるなど利点は大きい。また,手術を回避したり,より侵襲度の少ない縮小手術により口腔,顎,顔面領域の臓器・機能温存を図る治療形態も試みられてきている。本稿では,現時点での口腔進展癌に対するchemoradiotherapyの有用性と治療における位置付けを示し,将来展望についても言及した。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.5-6 p.213-22513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/83Journal of Nara Medical Association, 53(5-6): 213-225http://hdl.handle.net/10564/83http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/83/1/213-225p.%e5%8f%a3%e8%85%94%e7%99%8c%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e5%8c%96%e5%ad%a6%e3%83%bb%e6%94%be%e5%b0%84%e7%b7%9a%e4%bd%b5%e7%94%a8%e7%99%82%e6%b3%95%e3%81%a8%e8%87%93%e5%99%a8%e3%83%bb%e6%a9%9f%e8%83%bd%e6%b8%a9%e5%ad%98%e3%81%b8%e3%81%ae%e5%bf%9c%e7%94%a8%ef%bc%88%e6%a1%90%e7%94%b0%e5%bf%a0%e6%98%ad%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association535-62132252002-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/842017-05-29T06:06:34Zhdl_10564_1553病理診断学 過去、現在、未来DIAGNOSTIC PATHOLOGY. PAST, PRESENT AND FUTURE市島, 國雄山田, 英二吉川, 隆幸榎本, 泰典田村, 智美井上, 和也surgical pathologydiagnostic pathologyanatomical pathologybiopsy病理学は“疾病理論の学”であり,この中には疾病の本態,原因などを探求する基礎的研究と,これをもとにして疾病の診断を行う病理診断学の二つの方向がある。日本の病理学ではこれまで前者の基礎的な研究に重点がおかれ,数多くの優れた成果が得られている。後者の病理診断学では疾病の確定診断を行うことから患者の治療,予後などに重要な情報を提供し診療上極めて重要であり,特に近年臨床医学の発展に伴いその充実が求められるようになってきている。ここでは病理診断学について過去を振り返り,現在の問題点,未来の展望などを考
察する。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.5-6 p.227-23413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/84Journal of Nara Medical Association, 53(5-6): 227-234http://hdl.handle.net/10564/84http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/84/1/227-234p.%e7%97%85%e7%90%86%e8%a8%ba%e6%96%ad%e5%ad%a6%ef%bd%9e%e9%81%8e%e5%8e%bb%e3%80%81%e7%8f%be%e5%9c%a8%e3%80%81%e6%9c%aa%e6%9d%a5%ef%bd%9e%ef%bc%88%e5%b8%82%e5%b3%b6%e5%9c%8b%e9%9b%84%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association535-62272342002-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/852017-05-29T06:07:07Zhdl_10564_1553小児の尿路感染症の部位診断における尿中LDHアイソザイム分析の有用性URINARY LACTIC DEHYDROGENASE ISOENZYME ANALYSIS
AVAILABLE FOR LOCALIZING THE SITE OF INFECTION IN CHILDREN WITH URINARY TRACT INFECTION松永, 健司赤澤, 英樹武山, 雅博矢本, 陽子urinary LDH isoenzyme analysischildren,urinary tractinfection,urinary tract infectionpyelonephritiscystitisClinical differentiation between pyelonephritis and cystitis is often difficult to determine in infants and children. Precise localization of the site of infection is important from a therapeutic and prognostic standpoint in children with urinary tract infection (UTI). The present investigation was undertaken to determine whether or not
urinary lactic dehydrogenase (LDH) isoenzyme analysis could be available for
differentiation between upper UTI and lower UTI. Fourteen children 2 months to 15 yr
of age constituted the subjects for the study. Urinary LDH isoenzyme analyses were
performed using cellulose acetate membrane electrophoresis. On the basis of the patterns of urinary LDH isoenzymes, patients were divided into two groups. Of 14 patients, 10 (group I) showed predominant elevations of LDH1 and LDH2 (fast zone pattern) in the urine. In the remaining four (group II), urinary LDH predominantly consisted of LDH4 and LDH5 (slow zone pattern). Clinical findings revealed that body temperatures were
significantly higher in group II than in group I. Laboratory findings showed that the
serum levels of C-reactive protein (CRP) and urinary levels of β2 microglobulin were
slgnificantly higher in group II than in group I. Therefore, patients in group I were
compatible with lower UTI and patients in group II with pper UTI. This study shows the urinary LDH isoenzyme analysis to be useful for differentiation between upper UTI and lower UTI in children.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.5-6 p.235-23913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/85Journal of Nara Medical Association, 53(5-6): 235-239http://hdl.handle.net/10564/85http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/85/1/235-239p.%e5%b0%8f%e5%85%90%e3%81%ae%e5%b0%bf%e8%b7%af%e6%84%9f%e6%9f%93%e7%97%87%e3%81%ae%e9%83%a8%e4%bd%8d%e8%a8%ba%e6%96%ad%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e5%b0%bf%e4%b8%adLDH%e3%82%a2%e3%82%a4%e3%82%bd%e3%82%b6%e3%82%a4%e3%83%a0%e5%88%86%e6%9e%90%e3%81%ae%e6%9c%89%e7%94%a8%e6%80%a7%ef%bc%88%e6%9d%be%e6%b0%b8%e5%81%a5%e5%8f%b8%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association535-62352392002-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/862017-06-11T23:20:26Zhdl_10564_1553N-nitr osobis(2-oxopr opyl)amineによるハムスター膵管癌発生に対するウシおよびサメ軟骨水抽出物の影響EFFECTS OF BOVINE AND SHARK CARTILAGE WATER EXTRACTS ON PANCREATIC DUCTAL CARCINOGESIS IN HAMSTERS村田, 奈保hamsterpancreasshark cartilagechemopreventionEffects of shark cartilage water-extract (SCE) and bovine cartilage water-extract
(BCE) on pancreatic duct carcinogenesis were investigated using a rapid
production model for pancreatic duct carcinoma in hamsters, and the following results
were obtained.
1. SCE inhibited activities of MMP-2 and MMP-9 but BCE did not in vitro.
2. BCE did not have beneficial effects on chemoprevention of pancreatic carcinomas.
3. No toxic signs, including growth retardation or loss of pancreatic and liver weights, were observed in hamsters treated with BOP followed by SCE.
4. The diet containing O.4% SCE reduced significantly the numbers of adenocarcinomas
and ductallesions.
5. SCE did not affect the BrdU labeling indices of pancreatic ductal lesions.
6. SCE did not affect expression levels of proenzyme form of MMP-2 and MMP-9 and enzyme form of MMP-2 in adenocarcinomas.
These results indicate that SCE possesses inhibitory effects on development of pancreatic carcinomas and that SCE may be a candidate of chemopreventive agent for pancreatic carcinomas.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.5-6 p.241-25213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/86Journal of Nara Medical Association, 53(5-6): 241-252http://hdl.handle.net/10564/86http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/86/1/241-252p.N-nitr_osobis%282-oxopr_opyl%29amine%e3%81%ab%e3%82%88%e3%82%8b%e3%83%8f%e3%83%a0%e3%82%b9%e3%82%bf%e3%83%bc%e8%86%b5%e7%ae%a1%e7%99%8c%e7%99%ba%e7%94%9f%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e3%82%a6%e3%82%b7%e3%81%8a%e3%82%88%e3%81%b3%e3%82%b5%e3%83%a1%e8%bb%9f%e9%aa%a8%e6%b0%b4%e6%8a%bd%e5%87%ba%e7%89%a9%e3%81%ae%e5%bd%b1%e9%9f%bf%ef%bc%88%e6%9d%91%e7%94%b0%e5%a5%88%e4%bf%9d%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association535-62412522002-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/872017-06-11T23:20:26Zhdl_10564_1553動・静脈血栓形成過程に関する基礎的研究 走査および透過電子顕微鏡による観察EXPERIMENTAL STUDY OF ARTERIAL AND VENOUS
THROMBUS FORMATION BY SCANNING AND TRANSMISSION
ELECTRON MICROSCOPE金, 雄一arterial and venous thrombosisendothelial cellphotochemical dyeelectron microscoperatThe process of thrombus formation at arterial and venous endothelial surfaces was examined by scanning electron microscope (SEM) and transmission electron
microscope (TEM) in a photochemical occlusion model.The rats were divided into the following 4 groups after the injection of rose bengal:1) control group (n=5)without illumination; 2) group A (n=10) irradiated for 1 min; 3) group B (n=10) for 5 min; 4) group C (n=14) for lO min at cervical artery and vein. As a result, SEM findings showed adhesion of blood platelets and endothelial damage in neither artery nor vein in control and A groups. Plasma membrane damage of endothelial cells (i.e. plasmalemmal pits, the crater-like structure associated with tear between endothelial cells, and decreased number of microvilli) was recognized in arterial
wall, but these changes were not observed in vein in group B. Adhesion of blood
platelets in addition to endothelial cell membrane obstacle in artery was remarkable by SEM examination and tear between arterial endothelial cells was found by TEM
examination in group C. The degree of adhesion of platelets was clearly remarkable in artery compared with vein.
In conclusion, endothelial cell membrane injury, tear between endothelial cells and
endothelial detachment occur before adhesion of blood platelets and thrombus formation in a blood vessel occlusion model by photochemical reaction. These changes occur significantly earlier in artery than in vein.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.5-6 p.253-26113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/87Journal of Nara Medical Association, 53(5-6): 253-261http://hdl.handle.net/10564/87http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/87/1/253-261p.%e5%8b%95%e3%83%bb%e9%9d%99%e8%84%88%e8%a1%80%e6%a0%93%e5%bd%a2%e6%88%90%e9%81%8e%e7%a8%8b%e3%81%ab%e9%96%a2%e3%81%99%e3%82%8b%e5%9f%ba%e7%a4%8e%e7%9a%84%e7%a0%94%e7%a9%b6_-_%e8%b5%b0%e6%9f%bb%e3%81%8a%e3%82%88%e3%81%b3%e9%80%8f%e9%81%8e%e9%9b%bb%e5%ad%90%e9%a1%95%e5%be%ae%e9%8f%a1%e3%81%ab%e3%82%88%e3%82%8b%e8%a6%b3%e5%af%9f_-_%ef%bc%88%e9%87%91%e9%9b%84%e4%b8%80%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association535-62532612002-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/882017-05-29T06:06:35Zhdl_10564_1553出生当日に発症した発作性上室性頻拍症にATPが有効であった低出生体重児の1例SUCCESSFUL TREATMENT OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA IN A LOW-BIRTH-WEIGHT NEWBORN BY INJECTION OF ADENOSINE-5'-TRIPHOSPHATE古市, 康子吉田, 裕慈川口, 千晴桑原, 勲箕輪, 秀樹江國, 豊吉岡, 章高橋, 幸博松村, 正彦ATPparoxysmal supraventricular tachycardialow-birth-weight newbornWe report a case in which paroxysmal supraventricular tachycardia (PSVT) in a low-birth-weight newborn, due to atrioventricular nodal re-entry, was
successfully treated by intravenous bolus injection of adenosine-5'-triphosphate (ATP). The newborn was a male, born after 36 weeks and 1 day of gestation, weighing 2,204g. One hour after birth, he exhibited tachycardia, at 250 to 270 beats/min. A chest radiogragh revealed cardiomegaly, with a cardiothoracic ratio of 71%. Injection of ATP at a dose of O.3mg/kg resulted in complete cessation of PSVT, with temporary suppression of the sinus node and resumption of normal sinus rhythm within 10 seconds after injection.
No serious side effects of ATP injection occurred. Oral digoxin treatment was
administered for 10 months after ATP injection, to prevent recurrence of tachycardia. The patient is now 3 years and 2 months old, and there has been no recurrence of tachycardia.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.53 No.5-6 p.263-26713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/88Journal of Nara Medical Association, 53(5-6): 263-267http://hdl.handle.net/10564/88http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/88/1/263-267p.%e5%87%ba%e7%94%9f%e5%bd%93%e6%97%a5%e3%81%ab%e7%99%ba%e7%97%87%e3%81%97%e3%81%9f%e7%99%ba%e4%bd%9c%e6%80%a7%e4%b8%8a%e5%ae%a4%e6%80%a7%e9%a0%bb%e6%8b%8d%e7%97%87%e3%81%abATP%e3%81%8c%e6%9c%89%e5%8a%b9%e3%81%a7%e3%81%82%e3%81%a3%e3%81%9f%e4%bd%8e%e5%87%ba%e7%94%9f%e4%bd%93%e9%87%8d%e5%85%90%e3%81%ae1%e4%be%8b%ef%bc%88%e5%8f%a4%e5%b8%82%e5%ba%b7%e5%ad%90%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association535-62632672002-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/892017-05-29T06:09:25Zhdl_10564_1555表紙、目次、投稿規程、奥付(Vol.54 No.1)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.54 No.113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/89Journal of Nara Medical Association, 54(1)http://hdl.handle.net/10564/89http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/89/1/000p.%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5412003-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/902017-06-11T23:20:26Zhdl_10564_1555神経系細胞の損傷応答と分化 転写調節因子の機能解析を通じてMOLECULAR MECHANISMS OF INJURY-RESPONSE AND DIFFERENTIATION OF CNS CELLS-WITH SPECIAL REFERENCE TO TRANSCRIPTION FACTORS和中, 明生gliosisdifferential displayCREBLIM-homeodomain geneknock out mouse神経系細胞の損傷応答メカニズムと分化メカニズムについて,我々が同定した転写調節因子を軸に研究を行った。損傷応答に関しては特にグリア細胞の反応,グリオーシス現象に焦点を絞り培養細胞を用いたDifferential display法による遺伝子スクリーニングからCREBファミリーに属する新規遺伝子OASISの同定に成功した。OASIS蛋白はIn vitroの系で転写活性化能を持ち,in vivoでは脳損傷部位周囲のアストロサイトに発現する特徴を持つ。我々はOASISが従来から言われているグリオーシス組織の神経再生阻害作用に関与していると考え,現在この仮説を検証している。また脳損傷部位においては神経,グリア双方に分化しうる幹細胞の存在が注目されてきているが,我々も組織化学的手法を用いてこの幹細胞がアストロサイトへと分化する傾向が強いことを見出し,上記のOASISの機能と併せて損傷部位におけるグリア細胞の動態を検討している。分化メカニズムに関しては我々が同定したLIMホメオドメイン遺伝子ファミリーの一員であるL3/Lhx8の機能解析を行った。L3/Lhx8は胎生期の前脳基底部と口腔周囲に特異的に発現する特徴を持つ。LIMホメオドメイン遺伝子群は押しなべて組織,細胞の分化の制御のキー因子であることがノックアウトマウスの作成により次々と明らかとさ
れてきている。そこで我々も同遺伝子のノックアウトマウスを作成したところ,前脳基底部から発生するアセチルコリン作動性神経細胞の特異的脱落と口蓋裂の発生を認めた。前脳基底部のアセチルコリン作動性神経は記憶,学習機能に重要な役割を果たしており,L3/Lhx8遺伝子が高等動物の高次機能発現に不可欠な因子であることが示唆された。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.1 p.1-1213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/90Journal of Nara Medical Association, 54(1): 1-12http://hdl.handle.net/10564/90http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/90/1/001-012p.%e7%a5%9e%e7%b5%8c%e7%b3%bb%e7%b4%b0%e8%83%9e%e3%81%ae%e6%90%8d%e5%82%b7%e5%bf%9c%e7%ad%94%e3%81%a8%e5%88%86%e5%8c%96_-_%e8%bb%a2%e5%86%99%e8%aa%bf%e7%af%80%e5%9b%a0%e5%ad%90%e3%81%ae%e6%a9%9f%e8%83%bd%e8%a7%a3%e6%9e%90%e3%82%92%e9%80%9a%e3%81%98%e3%81%a6%ef%bc%88%e5%92%8c%e4%b8%ad%e6%98%8e%e7%94%9f%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5411122003-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/912017-06-11T23:20:26Zhdl_10564_1555Distribution of Lenticular Astigmatism in a Pre-Cataract Surgery PopulationSugie, YukoNawa, YoshiakiUeda, TetsuoKato, YoshikoMasuda, NorikoHara, Yoshiakitotal astigmatismcorneal astigmatismlenticular astigmatismwith-the-rule astigrlatismagainst-the-rule astigmatismRecently custom ablation of LASIK (laserin situ keratomileusis) has rapidly evolved. It could achieve supervision temporarily, but we suspect that the vision could deteriorate due to against-the rule astigmatism decades after the operation.
To clarify this concern, we evaluated distribution of the total and corneal astigmatism of 101 eyes of 65 pre-cataract surgery patients (meanage:73 years). Then we calculated the lenticular astigrlatism by vector analysis. The mean amounts of total and corneal astigmatism were 1.22±1.50D and 0.97±0.84D each. The percentages of no astigmatism: oblique: with-the-rule: against-the-rule were
32: 4: 15: 50 and 7: 28: 26: 40, respectively. The mean amount of lenticular astigrlatism measured by vector analysis was 1.6± 1.4D. The percentage of no astigmatism: oblique: with-the-rule: against-the-rule was 2: 0: 39: 59. This biased distribution of astigmatism might have contributed to the biased distribution (no and against-the-rule) of total astigmatism. These data indicate that in a pre-cataract surgery population against-the-rule astigmatism is predominant in both corneal and lenticular astigmatism. We suspect that custom correction of adolescent eyes, in which with-the-rule astigmatism is predominant, might elicit more against-the-rule astigmatism when they reach pre-cataract surgery age population, leading to a decline in quality of vision.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.1 p.13-1613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/91Journal of Nara Medical Association, 54(1): 13-16http://hdl.handle.net/10564/91http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/91/1/013-016p.Distribution_of_Lenticular_Astigmatism_in_a_Pre-Cataract_Surgery_Population%28Yuko_SUGIE_..._et_al.%29.pdf13450069AA11252383Journal of Nara Medical Association54113162003-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/922017-06-11T23:20:26Zhdl_10564_1555奈良県のがん罹患者数とがん登録精度 2000年奈良県がん登録結果CANCER INCIDENCE AND QUAUTY OF CANCER REGISTRATION IN NARA: RESULTS FROM NARA CANCER REGISTRY IN 2000佐伯, 圭吾車谷, 典男国安, 弘基大石, 元尾方, 希森田, 徳子松田, 亮三cancer incidencecancer registryDCNNara Cancer Registry was established in 1985 as a population-based cancer registry. Medical doctors in all medical facilities in Nara Prefecture are encouraged to report cancer patients with a registration form to Nara Cancer Registry. Additionally, of all death certificates submitted to the local authority, those recording the existence of any cancer are conveyed to the Registry. Reported cancer cases are referred to a database updated continuously since 1985 and then only incident cases are newly registered. The present study aimed at investigating cancer incidence and evaluating the quality of the registration uslng the data for the most recent year 2000 in Nara. We calculated age-adjusted incidence rates based on Japan standard population in 1985, the proportion of registered cancer patients who were reported by death certificate only (DCN %) and the ratio of the number of incident cases to that of deceased ones (I/Dratio).
In 2000, a total of 4,992 cancer patients (2,898 males and 2,094 females) were newly
registered. Age-adjusted incidence rates were 315.9 among males and 190.1 among
females for all sites. Sex ratio (315.9/190.1=1.7) was similar to the national average (365.3/224.7=1.6), but incident rates themselves for both sexes were O.85 times lower than the respective values ofJapan. Site specific and age-adjusted incidence rates showed the highest value in stomach cancer followed by lung cancer among males, and in breast cancer followed by stomach cancer among females. These descending orders were the same as those in the whole of Japan, but ranks of colon cancer in both sexes in Nara were unexpectedly low. DCN % was 50.9%, and I/D ratio was 1.52 for all cancers. These results suggest that not a few cancer patients may be underreported and that much effort is needed to improve the quality of cancer registration in Nara.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.1 p.17-2513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/92Journal of Nara Medical Association, 54(1): 17-25http://hdl.handle.net/10564/92http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/92/1/017-025p.%e5%a5%88%e8%89%af%e7%9c%8c%e3%81%ae%e3%81%8c%e3%82%93%e7%bd%b9%e6%82%a3%e8%80%85%e6%95%b0%e3%81%a8%e3%81%8c%e3%82%93%e7%99%bb%e9%8c%b2%e7%b2%be%e5%ba%a6_-_2000%e5%b9%b4%e5%a5%88%e8%89%af%e7%9c%8c%e3%81%8c%e3%82%93%e7%99%bb%e9%8c%b2%e7%b5%90%e6%9e%9c_-_%ef%bc%88%e4%bd%90%e4%bc%af%e5%9c%ad%e5%90%be%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association54117252003-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/932017-06-11T23:20:26Zhdl_10564_1555Dose-Related Decrease of Hemidesmosomes of the Rabbit Corneal Epithelium After Excimer Laser Photorefractive KeratectomySakagami, YushiNawa, YoshiakiTaketani, FutoshiHara, Yoshiakiexcimer laserPRKdesmosomesCurrently excimer laser photorefractive keratectomy (PRK) is widely performed to correct refractive errors. It has been recognized that it takes several months for attachment apparatus of the basement membrane of the comeal epithelium to reconstruct their original structure after laser ablation. We investigated dose-related
delay of the recovery of hemidesmosomes of the basement membrane of basal cells on the
comeal epithelium after PRK in rabbits. Three months after excimer laser ablation, the percentages of hemidesmosomes occupied by basement membrane were measured. The
results showed that the percentages significantly decreased as follows: PRK12D group < PRK3Dgroup < control group.
Although only two doses of laser ablation were tested, these results indicated that the more laser ablation the cornea received, the more delay of reconstruction of hemidesmosomes of the basal cells on the corneal epithelium occured.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.1 p.27-3213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/93Journal of Nara Medical Association, 54(1): 27-32http://hdl.handle.net/10564/93http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/93/1/027-032p.Dose-Related_Decrease_of_Hemidesmosomes_of_the_Rabbit_Corneal_Epithelium_After_Excimer_Laser_Photorefractive_Keratectomy%28Yushi_SAKAGAMI_..._et_al.%29.pdf13450069AA11252383Journal of Nara Medical Association54127322003-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/942017-05-29T06:07:05Zhdl_10564_1555ヒト口腔扁平上皮癌におけるリン酸化型ERKおよびMKP-1の発現についてEXPRESSION OF PHOSPHORYLATED ERK AND MKP-l IN HUMAN ORAL SQUAMOUS CELL CARCINOMA井上, 和也榎本, 泰典市島, 國雄美島, 健二山田, 英二島田, 啓司小西, 登桐田, 忠昭extracellular signal-regulated kinase(ERK)mitogen-activated protein kinaseoral squamous cell carcinoma(OSCC)Mitogen-activated protein (MAP) kinase cascades are activated in response to various extracellular stimuli. Extracellular signal-regulated kinase (ERK), a MAPK subfamily, are activated by many oncogenes including ras and raf, which are closely associated with cell growth and differentiation. There is a report that ERK is highly expressed in oral squamous cell carcinoma (OSCC) but it does not include activated forms of ERK (phosphorylated ERK, pERK). Here we examined expression of pERK by immunohistochemical method in 50 OSCC and 7 normal gingival mucosa cases. The
positive ratios of immunoreactivity for pERK in nuclei of cells were higher in OSCC than in normal gingival mucosa. Index of pERK was correlated with Ki-67 index.
Interestingly, pERK was also expressed in Ki-67 negative cells in OSCC. Next, we investigated distribution and expression of mitogen-activated protein kinase phosphatase-1 (MKP-1), which dephosphorylates and inactivates ERK, by the methods of immunohistochemistry and in situ hybridization (ISH). The distribution of positive signals for protein and mRNA expression of MKP-1 showed almost the same results as demonstrated in pERK. The expression of MKP-1 protein by Western blot analysis was seen in all cases, and the expression in several cases of OSCC was higher than that in normal ginglval mucosa.
The results raise a possibility that MKP-1 might be activated in response to ERK
activation in cancer cells and suggest that the interaction of two molecules play an
important role in proliferation and differentiation of OSCC. Moreover, the assay of MKP-1 expression as well as ERK should provide a good clue to assess the progression or prognosis of OSCC.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.1 p.33-4213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/94Journal of Nara Medical Association, 54(1): 33-42http://hdl.handle.net/10564/94http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/94/1/033-042p.%e3%83%92%e3%83%88%e5%8f%a3%e8%85%94%e6%89%81%e5%b9%b3%e4%b8%8a%e7%9a%ae%e7%99%8c%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e3%83%aa%e3%83%b3%e9%85%b8%e5%8c%96%e5%9e%8bERK%e3%81%8a%e3%82%88%e3%81%b3MKP-1%e3%81%ae%e7%99%ba%e7%8f%be%e3%81%ab%e3%81%a4%e3%81%84%e3%81%a6%ef%bc%88%e4%ba%95%e4%b8%8a%e5%92%8c%e4%b9%9f%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association54133422003-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/952017-05-29T06:07:07Zhdl_10564_1555腸閉塞症状を来した旋尾線虫幼虫typeX感染例A CASE OF ILEUS BY THE INFECTION OF TYPE X LARVAE OF THE SUBORDER SPIRURINA AFTER EATING RAW FIREFLY SQUIDS吉川, 正英城井, 啓王寺, 幸輝美留町, 潤一西村, 文彦横田, 浩石坂, 重昭米田, 諭松森, 篤史山根, 佳子安藤, 稔西村, 公男山尾, 純一福井, 博内山, ふくみ名和, 行文赤尾, 信明larva mlgransWatasenia scintillanssplruroid nematodesileusA 53-year-old male was hospitalized on April 12th, 2002 because of an upper abdominal pain that started in the morning of April 11th and gradually worsened. Ileus
was suspected based on an X-ray of the abdomen. A medical interview revealed that the patient had eaten raw firefly squids, 2 days before the hospitalization. The abdominal symptoms disappeared in a few days during which the patient was treated
conservatively. A specimen from the patient's sera reacted with the esophageal glands in frozen sections of a type X larva of the suborder Spirurina. The infection of the type X larvae of unidentified splruroid nematodes from squids was considered to be the cause, because those larvae have recently been to reported as the cause of visceral and cutaneous. Although the infection rate in W. scintillans is relatively low, a risk of human infection with type X larvae should be taken into a consideration in the consumption of raw squids.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.1 p.43-4713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/95Journal of Nara Medical Association, 54(1): 43-47http://hdl.handle.net/10564/95http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/95/1/043-047p.%e8%85%b8%e9%96%89%e5%a1%9e%e7%97%87%e7%8a%b6%e3%82%92%e6%9d%a5%e3%81%97%e3%81%9f%e6%97%8b%e5%b0%be%e7%b7%9a%e8%99%ab%e5%b9%bc%e8%99%abtypeX%e6%84%9f%e6%9f%93%e4%be%8b%ef%bc%88%e5%90%89%e5%b7%9d%e6%ad%a3%e8%8b%b1%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association54143472003-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/962017-05-29T06:07:04Zhdl_10564_1555内視鏡的に切除できた十二指腸腺腫の1症例TUBUILO-VILLOUS ADENOMA OF DUODENUM REMOVED
BY ENDOSCOPIC POLYPECTOMY辰巳, 満俊西沼, 亮tubulo-villous adenomaduodenum, endoscopic polypectomyA 51-year-old man was found to have an abnormal polypoid lesion on UGIs of a health examination and was adrnitted to our hospital. Duodenogram showed a pedunculated polypoid lesion (12mm in diameter) in the third portion of the duodenum and endoscopic examination revealed that the surface was villous. The histological
diagnosis of a biopsy specimen was villous adenoma. Endoscopic polypectomy was performed without any accidental complications. Histology of resected specimen revealed tubulo-villous adenoma with no malignancy. Although opportunities to detect duodenal polypoid lesions are increasing recently, tubulo-villous adenoma of the third portion of the duodenum is rare.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.1 p.49-5213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/96Journal of Nara Medical Association, 54(1): 49-52http://hdl.handle.net/10564/96http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/96/1/049-052p.%e5%86%85%e8%a6%96%e9%8f%a1%e7%9a%84%e3%81%ab%e5%88%87%e9%99%a4%e3%81%a7%e3%81%8d%e3%81%9f%e5%8d%81%e4%ba%8c%e6%8c%87%e8%85%b8%e8%85%ba%e8%85%ab%e3%81%ae1%e7%97%87%e4%be%8b%ef%bc%88%e8%be%b0%e5%b7%b3%e6%ba%80%e4%bf%8a%e3%80%81%e8%a5%bf%e6%b2%bc%e4%ba%ae%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association54149522003-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/972017-05-29T06:06:34Zhdl_10564_1556表紙、目次、投稿規程、奥付(Vol.54 No.2)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.54 No.213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/97Journal of Nara Medical Association, 54(2)http://hdl.handle.net/10564/97http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/97/1/000p.%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5422003-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/982017-05-29T06:07:07Zhdl_10564_1556死体が語るものMESSAGE FROM THE DEAD BODY羽竹, 勝彦messagedead bodyinquestmedicolegal death法医学の解剖対象は異状死体である。その死は病死の人も多いが,殺人,交通事故,溺死,焼死など外因的要因で死亡する人が大半である。日常,法医学の解剖業務において様々な死に出会っている。その中で死者の語りかけを感じることがある。死者が発するメッセージを死亡状況や死体所見から読み取り,それにより死因や死後経過時間など医学的判断を正確に下せることがある。もう一つは様々な様態で死亡する死者が生者に対して送る人生論的メッセージである。本稿では死体の検案解剖に際して,死者の語りかけを法医学本来の観点と生や死という観点から述べた。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.2 p.53-6313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/98Journal of Nara Medical Association, 54(2): 53-63http://hdl.handle.net/10564/98http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/98/1/053-063p.%e6%ad%bb%e4%bd%93%e3%81%8c%e8%aa%9e%e3%82%8b%e3%82%82%e3%81%ae%ef%bc%88%e7%be%bd%e7%ab%b9%e5%8b%9d%e5%bd%a6%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association54253632003-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/992017-05-29T06:06:34Zhdl_10564_1556ナトリウム利尿ペプチドNATRIURETIC PEPTIDES斉藤, 能彦ANPBNPcongenstve heart failure心房性ナトリウム利尿ペプチド(ANP)は1983年にヒト心房より発見された心臓ホルモンであり,利尿,ナトリウム利尿,血管拡張,アルドステロン分泌抑制等の多彩な生物作用を有している。ANPの発見は,心臓の役割はポンプ器官として血液を全身に送り出すこととの概念
を一変させた。ANPに引き続いて第2,第3のファミリーである,脳性ナトリウム利尿ペプチド(BNP),C型ナトリウム利尿ペプチド(CNP)が発見され,これらのペプチドはファミリーとして多彩な生物現象に関与していることが明らかになってきた。ANPとBNPは心臓ホルモンで
あり,ANPは主として心房で,BNPは主として心室から分泌され,様々な心疾患の病態生理に関与している。心不全においてはBNPの分泌量は著増し,心不全のマーカーとして診断に有用であることが証明されつつあり,ANPは心不全の治療薬として広く使用されている。本稿では,ナトリウム利尿ペプチドの発見から臨床応用までを概説したい。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.2 p.65-7513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/99Journal of Nara Medical Association, 54(2): 65-75http://hdl.handle.net/10564/99http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/99/1/065-075p.%e3%83%8a%e3%83%88%e3%83%aa%e3%82%a6%e3%83%a0%e5%88%a9%e5%b0%bf%e3%83%9a%e3%83%97%e3%83%81%e3%83%89%ef%bc%88%e6%96%89%e8%97%a4%e8%83%bd%e5%bd%a6%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association54265752003-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1002017-06-11T23:20:26Zhdl_10564_1556Relationship of Metallothionein to Zinc Metabolism During PregnancyMinami, TakeshiNaganuma, TakashiWatanabe, MarikoTakemura, Hideometallothioneinzincβ2-microgloblinamniotic fluidThe amounts of metallothionein (MT) and related substances in amniotic fluid and urine were measured, and the role of the MT contained in these fluids was studied. Amniotic fluid without blood was collected during Caesarian sections. Total urine
obtained during one day was collected from newborn infants (0-6 days), and spot urine
was collected from pregnant women. Sera were also collected. MT in amniotic fluid and urine was measured by radioimmunoassay. In amniotic fluid, a positive relation was
observed between MT and β2-microgloblin (MG), but not between MT and zinc. In contrast, a positive relation was observed between MT and zinc in urine of newborn
infants, but not between MT and MG. Serum zinc levels were significantly lower in
postpartum women than healthy young women, and urinary zinc levels were markedly higher in newborn infants than healthy young women. In conclusion, the level of MT in amniotic fluid may reflect fetal renal function, and another function of MT in the fetus and newborn infant is to supplement zinc in the body.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.2 p.77-8213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/100Journal of Nara Medical Association, 54(2): 77-82http://hdl.handle.net/10564/100http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/100/1/077-082p.Relationship_of_Metallothionein_to_Zinc_Metabolism_During_Pregnancy%28Takeshi_MINAMI_..._et_al.%29.pdf13450069AA11252383Journal of Nara Medical Association54277822003-04-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1012017-06-11T23:20:26Zhdl_10564_1556Work-Related Musculoskeletal Disorders and Associated Factors in Teachers of Physically and Intellectually Disabled PupilsYamamoto, NobuhiroSaeki, KeigoKurumatani, Noriodisabled childrenquestionnaire studyrisk factorsteacherswork-related musculoskeletal disordersTeachers in schools for physically and intellectually disabled pupils are assumed to have a risk of developing usculoskeletal disorders including the cervicobrachial and lower back regions. To date, however, studies concerning these issues are extremely limited. The present study aimed at clarifying the magnitude of the musculoskeletal disorders among the teachers, its work-relatedness and associated factors. First, we conducted self-administered questionnaires and medical checkups simultaneously for 126 female nursery school nurses to ascertain the validity of questions and answer options which we developed for epidemiologic research. Questions "haveyou
had any pain or stiffness in your neck, shoulders or arms in the past month?" and "have you had any pain or stiffness in your lower back?", and an answer option "almost all day, everyday" were found to correlate well with the results of clinical examinations and difficulties in daily activities. Secondly, we analyzed self-administered questionnaires of
975 teachers working for physically and intellectually disabled pupils at municipal
schools in a city. The questions and answer options which had been validated in the first study were used. In the males 16% and 20% complained "almost all day, everyday" of the cervicobrachial and lower back symptoms, respectively, and in the females 20% and 16% in that order. Adjusted odds ratios of both symptoms increased with an increase in objective scores which were obtained by the homogeneity analysis and were considered to reflect the quantity of nursing care burden on the teachers. In case of the cervicobrachial symptom females against males had a significantly higher odds ratio than unity. These results demonstrated that the musculoskeletal symptoms complained of highly by the teachers were work-related, and that the question and answer options we developed could be useful parameters in epidemiologic research for the symptoms now widely prevailing in various workplaces.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.2 p.83-10113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/101Journal of Nara Medical Association, 54(2): 83-101http://hdl.handle.net/10564/101http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/101/1/083-101p.Work-Related_Musculoskeletal_Disorders_and_Associated_Factors_in_Teachers_of_Physically_and_Intellectually_Disabled_Pupils%28Nobuhiro_YAMAMOTO%29.pdf13450069AA11252383Journal of Nara Medical Association542831012003-04-30engauthor
oai:ginmu.naramed-u.ac.jp:10564/1022017-05-29T06:07:07Zhdl_10564_1556高井病院歯科口腔外科開設後5年間における新患患者の臨床的観察CLINICAL OBSERVATION OF PATIENTS AT DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY, TAKAI HOSPITAL DURING THE FIRST FIVE YEARS大儀, 和彦山中, 康嗣関東, 里衣今井, 裕一郎河野, 太郎岸, 宗弘黒瀬, 尚利植村 , 和嘉桐田, 忠昭oral and maxillofacial surgeryclinical observationfirst five yearsClinical observations were performed during the first 5 years (1996.7-2001.7)
of new patients at the Department of Oral and Maxillofacial Surgery, Takai Hospital. The
followlng results were obtained.
1. The total number of new patients was 4,080. The male-female ratio was 1:1. Many of
the patients were in their 20s. The youngest patient was 6 months old and the oldest
patient was 100 years old.
2. The yearly average number of new patients was 780. 1,844 patients (45.2%) had
diseases associated with oral and maxillofacial surgery, and 2,236 patients (54.8%) were
dentistry.
3. More than 75% of the patients resided in Nara City, Tenri City, and Yamatokoriyama
City.
4. 974 patients (69.7%) who had diseases associated with oral and maxillofacial surgery
were referred from dental offices, within the hospital and other hospitals. The number
of patients introduced to our hospital year by year.
5. 1,118 patients (27.4%) were medically compromised patients, and these patients were
almost all more than 60 years old. Of medically compromised patients, hyper tension
was found in 510 patients (36.9%).
6. The number of inpatients who underwent an operation in the central room was 272
cases, and mainly resulting from maxillofacial trauma. The number of in out patients
was 967 cases, and most of them receiving extraction of impacted third molar.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.2 p.103-11213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/102Journal of Nara Medical Association, 54(2): 103-112http://hdl.handle.net/10564/102http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/102/1/103-112p.%e9%ab%98%e4%ba%95%e7%97%85%e9%99%a2%e6%ad%af%e7%a7%91%e5%8f%a3%e8%85%94%e5%a4%96%e7%a7%91%e9%96%8b%e8%a8%ad%e5%be%8c5%e5%b9%b4%e9%96%93%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e6%96%b0%e6%82%a3%e6%82%a3%e8%80%85%e3%81%ae%e8%87%a8%e5%ba%8a%e7%9a%84%e8%a6%b3%e5%af%9f%ef%bc%88%e5%a4%a7%e5%84%80%e5%92%8c%e5%bd%a6%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5421031122003-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1032017-06-11T23:20:26Zhdl_10564_1556Molecular Mechanism of Arsenic Trioxide-Induced Apoptosis in HL-60 and Cell LinesZhu, JiebinNakamura, Shinobuarsenic trioxideHL-60RLapoptosisCD95/CD95L pathwayRecently, it has been reported that arsenic trioxide (As2 O3) is an effective
anticancer agent for acute promyelocytic leukemia (APL). In the present study, we
examined the anticancer effects of As2 O3 at low concentration (0.25~2.OμM) on two hunan
leukemia/lymphoma cell lines, HL-60 and RL, in vitro. We found that As2 O3 inhibited the
growth of HL-60 and RL similar to the reported APL cell line, NB4. Typical apoptosis
was observed in morphologlcal study and DNA fragmentation assay, as well as a cell
cycle arrest at subG1. To address the mechanism of As2 03-induced apoptosis, we also
examined the effect of As2 O3 on the CD95/CD95L pathway and bcl-2 protein expression.
The results showed that the CD95/CD95L expressions were upregulated; meanwhile,
caspase 8 and caspase 3 were activated. However, the bcl-2 protein expression was
downregulated. Using anti-CD95 monoclonal antibody to block the CD95 pathway,
As2 O3 - induced apoptosis was ameliorated. These data suggest that in HL-60 and RL cell
lines the CD95/CD95L pathway and downregulation of bc1-2 protein expression are
invoIved in As2 O3-induced apoptosis.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.2 p.113-12313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/103Journal of Nara Medical Association, 54(2): 113-123http://hdl.handle.net/10564/103http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/103/1/113-123p.Molecular_Mechanism_of_Arsenic_Trioxide-Induced_Apoptosis_in_HL-60_and_Cell_Lines%28Jiebin_ZHU_and_Shinobu_NAKAMURA%29.pdf13450069AA11252383Journal of Nara Medical Association5421131232003-04-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1042017-05-29T06:06:34Zhdl_10564_1556高度の血小板増多を呈した骨髄異形成症候群の1例A CASE OF MYELODYSPLASTIC SYNDROME WITH REMARKABLE THROMBOCYTOSIS団野, 大介神野, 正敏藤本, 眞一中村, 忍川田, 啓之原田, 幸児中谷, 公彦橋本, 俊雄MDSRAEB-TthrombocytosisA 69-year-old woman was admitted to our hospital because of gingival
bleeding on May 1997. She had been our outpatient for treatment of angina pectoris since
1987. She had had stomatorrhagia and slight fever since April 1997. On the present
admission, she had normocytic normochromic anemia and myeloblast with Auer bodies in
her peripheral blood. She also had dysplasia in her marrow cells. She was diagnosed as
having MDS (RAEB-T). Although MDS is usually associated with pancytopenia, this
patient had remarkable thrombocytosis. The 5q-syndrome sometimes has thrombocytosis.
However, her chromosome analysis showed normal karyotype, and she did not have
chromosome aberration. Thrombopoietin and IL-6 which are known as growth factors of
platelet did not increase. The present case is a rare case of MDS with remarkable
thrombocytosis. Her thrombocytosis may have been caused by neoplastic increase of
megakaryocyte and platelet in bone marrow.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.2 p.125-13013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/104Journal of Nara Medical Association, 54(2): 125-130http://hdl.handle.net/10564/104http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/104/1/125-130p.%e9%ab%98%e5%ba%a6%e3%81%ae%e8%a1%80%e5%b0%8f%e6%9d%bf%e5%a2%97%e5%a4%9a%e3%82%92%e5%91%88%e3%81%97%e3%81%9f%e9%aa%a8%e9%ab%84%e7%95%b0%e5%bd%a2%e6%88%90%e7%97%87%e5%80%99%e7%be%a4%e3%81%ae1%e4%be%8b%ef%bc%88%e5%9b%a3%e9%87%8e%e5%a4%a7%e4%bb%8b%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5421251302003-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1052017-05-29T06:09:10Zhdl_10564_1557表紙、目次、投稿規程、奥付(Vol.54 No.3)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.54 No.313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/105Journal of Nara Medical Association, 54(3)http://hdl.handle.net/10564/105http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/105/1/000p.%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5432003-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1062017-05-29T06:07:07Zhdl_10564_1557血友病Aの分子病態学における進歩ADVANCES IN THE MOLECULAR PATHOPHYSIOLOGY OF HEMOPHILIA A嶋, 緑倫factor Ⅷfactor Ⅷ genethrombininhibitor抄録:血友病Aは第Ⅷ因子の量的質的異常に基づく出血性疾患である。第Ⅷ因子は血漿中ではフォンヴィレブランド因子と複合体を形成して存在している。第Ⅷ因子はトロンビンや活性型第Ⅹ因子により活性化されて第Ⅹ因子活性化酵素複合体において必須の補因子として機能して
いる。フォンヴィレブランド因子は第Ⅷ因子を不活性化する活性化プロテインCを抑制して第Ⅷ因子の凝固活性を保護している。血友病Aの臨床的重症度は第Ⅷ因子の活性によく相関する。血友病Aの第Ⅷ因子遺伝子異常は逆位,点変異,欠失,挿入など計629種類の変異が明らかにされている。さらに血友病A変異病型の異常第Ⅷ因子の解析も進んでいる。トロンビン開裂異常をきたしたF Ⅶ OkayamaやF Ⅶ Hiroshimaが代表的である。血友病Aの一部に第Ⅷ国子製剤の補充療法の結果,抗第Ⅷ因子同種抗体(インヒビター)が発生する。インヒビターは第Ⅷ
因子の活性を低下あるいは消失する。インヒビターの主要結合部位は重鎖A2および軽鎖C2ドメインである。最近,ペプチドレベルの詳細なエピトープ解析が行われている。さらに,インヒビターの第Ⅷ国子抑制機序として,第Ⅷ国子とフォンヴィレブランド因子,活性型第Ⅹ因子,トロンビン,リン脂質などの結合抑制が明らかにされている。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.3 p.131-14513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/106Journal of Nara Medical Association, 54(3): 131-145http://hdl.handle.net/10564/106http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/106/1/131-145p.%e8%a1%80%e5%8f%8b%e7%97%85A%e3%81%ae%e5%88%86%e5%ad%90%e7%97%85%e6%85%8b%e5%ad%a6%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e9%80%b2%e6%ad%a9%ef%bc%88%e5%b6%8b%e7%b7%91%e5%80%ab%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5431311452003-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1072017-05-29T06:06:34Zhdl_10564_1557ハイドロゲルを用いた人工硝子体の研究RESEARCH OF HYDROGEL AS A VITREOUS SUBSTITUTE松浦, 豊明丸岡, 真治川崎, 健輔原, 嘉昭安中 , 雅彦児玉, 亮vitreous bodyhydrogelvitreoussubstitute and PVA硝子体手術に用いられる硝子体代用物について,シリコンオイル,ガスなど現在臨床応用されている医療材料の利点と問題点を考え,ハイドロゲルを人工硝子体として考えて研究を行っている。その歴史と展望について述べた。また生体の硝子体は構造と異方性を持ったハイドロゲルであり,そのゲルとしての構造,更に体積相転移が臨床的な網膜,硝子体疾患と関わっていることを示した。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.3 p.147-15913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/107Journal of Nara Medical Association, 54(3): 147-159http://hdl.handle.net/10564/107http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/107/1/147-159p.%e3%83%8f%e3%82%a4%e3%83%89%e3%83%ad%e3%82%b2%e3%83%ab%e3%82%92%e7%94%a8%e3%81%84%e3%81%9f%e4%ba%ba%e5%b7%a5%e7%a1%9d%e5%ad%90%e4%bd%93%e3%81%ae%e7%a0%94%e7%a9%b6%ef%bc%88%e6%9d%be%e6%b5%a6%e8%b1%8a%e6%98%8e%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5431471592003-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1082017-06-11T23:20:26Zhdl_10564_1557Arsenic Trioxide Induces Oncosis in K562 Cell Line Via CD95 CD95L PathwayZhu, JiebinNakamura, Shinobuarsenic trioxideoncosisK562CD95/CD95L pathwaybcl-2Recently it has been reported that arsenic trioxide (As203) is very
effective in the treatment of acute promyelocytic leukemia (APL) by inducing apoptosis,
but the molecular mechanism of its action on other leukemia remains unclear. In the
present study, we tested the effect of As2 O3 at low concentration O.25-2.O μM on K562, a
chronic myelogenous leukemia cell line. As2 03 inhibited the cell growth of K562 in a
similar way to APL cell line NB4. Typical oncotic cell death, such as cytoplasmic
swelling and swelling of organelles, was observed by morphological study and cell cycle
was arrested at G2+M phases. During the treatment of As2 03, the CD95 and CD95 ligand
(CD95L) expressions were upregulated, and caspase 8 and caspase 3 were activated, but
bcl-2 expression was not changed. Treatment of the cells with anti-CD95 monoclonal
antibody or ZVAD-fmk capable of blocking the CD95 signaling pathway ameliorated
As2 03-induced oncosis. These results suggest that the induction of oncosis by As2 03
invoIves CD95/CD95L pathway in K562 and As2 03 may provide a novel therapy for
leukemia other than APL.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.3 p.161-17013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/108Journal of Nara Medical Association, 54(3): 161-170http://hdl.handle.net/10564/108http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/108/1/161-170p.Arsenic_Trioxide_Induces_Oncosis_in_K562_Cell_Line_Via_CD95_CD95L_Pathway%28Jiebin_ZHU%2c_Shinobu_NAKAMURA%29.pdf13450069AA11252383Journal of Nara Medical Association5431611702003-06-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1092017-05-29T06:06:50Zhdl_10564_1557当科での食道癌手術における器械吻合導入後の成績THE RESULTS OF ESOPHAGOGASTRIC ANASTOMOSIS FOR ESOPHAGEAL CANCER WITH A CIRCULAR STAPLER阪口 , 晃行渡辺, 明彦山本, 克彦石川, 博文山田, 高嗣大槻, 憲一横谷, 倫世esophagogastric anastomosiscircular staplerintra-thoracic anastomosiscervical anastomosisWe have utilized a circular stapler for intra-thoracic anastomosis (ITA)
after radical esophagectomy since July 1999, and moreover, for cervical anastomosis (CA)
since July 2001. In this study,we evaluate the usefulness of esophagogastric
anastomosis with a circular stapler. Subjects were 28 esophageal patients who
underwent esophagectomy followed by esophagogastric anastomosis with a circular
stapler in the period from July 1999 to February 2003. Esophagogastric anastomosis with
a circular stapler was performed by end to side anastomosis. Subjects consisted of 20
cases undergoing ITA and 8 cases undergolng CA. The incidences of anastomotic
leakage were 15.0% and 12.5%, respectively. The cases with anastomotic leakage were
treated with a conservative therapy and cured. The incidences of anastomotic stenosis in
ITA and CA were 15.0% and 12.5%, respectively. Anastomotic stenosis occurred from one
to six months after operation in the cases without anastomotic leakage. One or two
balloon dilatation could not relieved in 3 of the 4 cases with anastomotic stenosis.
Anastomotic bleeding was not found. There was only one case with severe reflex
esophagitis in ITA. We are almost satisfied with these results. Therefore, it was thought
that esophagogastric anastomosis with a circular stapler isuseful.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.3 p.171-17413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/109Journal of Nara Medical Association, 54(3): 171-174http://hdl.handle.net/10564/109http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/109/1/171-174p.%e5%bd%93%e7%a7%91%e3%81%a7%e3%81%ae%e9%a3%9f%e9%81%93%e7%99%8c%e6%89%8b%e8%a1%93%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e5%99%a8%e6%a2%b0%e5%90%bb%e5%90%88%e5%b0%8e%e5%85%a5%e5%be%8c%e3%81%ae%e6%88%90%e7%b8%be%ef%bc%88%e9%98%aa%e5%8f%a3%e6%99%83%e8%a1%8c%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5431711742003-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1102017-05-29T06:07:07Zhdl_10564_1557早期胃癌に対する内視鏡的胃粘膜切除(EMR)後の胃切除症例の検討SURGICAL OPERATION AFTER ENDOSCOPIC MUCOSAL RESECTION(EMR)阪口, 晃行渡辺, 明彦山本, 克彦石川, 博文山田, 高嗣大槻, 憲一横谷, 倫世salvage gastrectomyendoscopic mucosal resection (EMR)Laparoscopic operationsSixteen cases were treated with salvage gastrectomy after endoscoplc
mucosal resection (EMR) for early gastric cancer in Nara Prefectural Nara Hospital from
1996 to 2002. The residual cancer cells and lymph node metastases were pathologlcally
evaluated in comparing the findings of EMR-specimens. The reasons for salvage
gastrectomy are described below. Twelve cases were treated for 'positive surgical
margin'. Two cases that were not proved 'negative surglcal margin' in the EMR-specimens
were underwent salvage gastrectomy for remnant cancer at 4 and 9 months
after EMR. Although one case was 'negative surglcal margin', salvage gastrectomy was
performed because of the patient's choice. One case was a recurrent case after curative
EMR. In resected specimens, remnant cancer cells were observed in 12 of all 16 cases
(75.0%), 11 of 14 cases that were not proved 'negative surgical margin' (78.6%) in the
EMR specimens. Lymph node metastasis was not found in all cases. Although one case
was mucosal cancer with 'positive surgical margin' in EMR-specimens, salvage
gastrectomy was not performed because no cancer cells were observed by follow-up
gastrofiberscopy in the EMR-scar and the patient's choice. In this case, the follow-up
gastrofiberscopy at 9 months after EMR proved cancer cells and laparoscopy assisted
distal gastrectomy was perfomed. The surgical specimen pathlogically showed
submucosal invasion. Laparoscoplc gastrectomy as minimally invasive surgery was
performed in 6 of 16 cases. In conclusion, surgical operation should be performed as
soon as possible for remnant and recurrent gastric cancer after EMR and if possible,
laparoscoplc operations would be a good choice.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.3 p.175-17913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/110Journal of Nara Medical Association, 54(3): 175-179http://hdl.handle.net/10564/110http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/110/1/175-179p.%e6%97%a9%e6%9c%9f%e8%83%83%e7%99%8c%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e5%86%85%e8%a6%96%e9%8f%a1%e7%9a%84%e8%83%83%e7%b2%98%e8%86%9c%e5%88%87%e9%99%a4%ef%bc%88EMR%ef%bc%89%e5%be%8c%e3%81%ae%e8%83%83%e5%88%87%e9%99%a4%e7%97%87%e4%be%8b%e3%81%ae%e6%a4%9c%e8%a8%8e%ef%bc%88%e9%98%aa%e5%8f%a3%e6%99%83%e8%a1%8c%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5431751792003-06-30jpnauthor
oai:ginmu.naramed-u.ac.jp:10564/1122017-06-11T23:20:26Zhdl_10564_1557Intra-Day Variation of Urinary Nuclear Matrix Protein 22Fukui, YoshihisaSamma, ShcuiYamaguchi, AkiraAoki, KatsuyaShimizu, AzuhiroNMP22urothelial cancerurinary tumor markerintra-day variationNuclear Matrix Protein 22 (NMP22), a urinary tumor marker for urothelial
cancers, is directly released into the urine from the nucleus after cell death, Accordingly,
values of NMP22 do not requlre adjustment using other substances such as urinary
creatinine. On the other hand, its values might vary according to urine concentration.
This study investigated the intra-day variation in the urinary level of NMP22. NMP22
and urinary creatinine were measured in a 24-hour urine sample and 4 spot urine
samples obtained from 20 inpatients (10 with bladder cancer, and 10 with non-urothelial
cancer or benign tumors). The spot urine samples were collected at 6 a.m., 10 a.m., 2p.m.
and 9 p.m. There were no significant differences in NMP22 values between the 24-hour
and spot samples in all patients. Out of 10 bladder cancer patients, 6 had positive
24-hour samples. Among these 6 patients, only 3 had 4 positive spot samples (>12.O
U/ml): one had 3 positive samples, and 2 had one positive sample. Among the controls,
only one patient with renal cancer had a positive 24-hour sample. Only 3 controls, 2 With
prostatic cancer and one with renal cancer, had a single positive spot sample. The
highest margin between the maximum and minimum levels in the 4 spot samples was
237.8 U/ml in the bladder cancer patients and 16.6 U/ml in the controIs. When the ratios
of NMP22 and urinary creatinine values for the 24-hour to spot samples were calculated
in each patient, a significant correlation was observed between the ratios of NMP22 and
urinary creatinine (r=0.575, p<0.001). The urinary level of NMP22 shows intra-day
variation and might be affected by the extent of the concentration of urine samples. The
measurement results must be judged with this in mind, especially when judging the
results around the cut-off value.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.3 p.181-18813450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/112Journal of Nara Medical Association, 54(3): 181-188http://hdl.handle.net/10564/112http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/112/1/181-188p.Intra-Day_Variation_of_Urinary_Nuclear_Matrix_Protein_22%28Yoshihisa_FUKUI_..._et_al.%29.pdf13450069AA11252383Journal of Nara Medical Association5431811882003-06-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1132017-06-11T23:20:26Zhdl_10564_1557超音波断層検査で偶然発見された胃の有茎性壁外発育型Gastrointertinal stromal tumor(GIST)の1例GASTROINTESTINAL STROMAL TUMOR WITH EXOGASTRIC
PEDUNCULATED DEVELOPMENT DIAGNOSED BY ULTRASONOGRAPHY辰巳, 満俊西沼, 亮安川, 十郎GISTpedunculated typeextra-gastric typeA 55-year-old woman was admitted to our hospital complaining of
epigastral distress. Endoscopy of the gastro-intestinal tract revealed no remarkable
finding, but a tumor was detected near the kidney by abdominal ultrasonography.
Computerized tomography revealed that the tumor had a lower density than that of the
liver, and was enhanced by CE/CT. Operative findings showed that the tumor had
grown out of the gastric wall with a short peduncle derived from the posterior wall of the
stomach. It was diagnosed as a gastrointestinal stromal tumor with exogastric
pedunculated development. Pathological examination revealed that the tumor had little
symptom of malignancy such as frequent mitosis, and that it was connected to the
muscular layer of the gastric wall by the thin peduncle. Immunohistdlogical study
confirmed that the tumor was the smooth muscle type of GIST because of the positive
expression of CD34, c-kit and αSMA.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.3 p.189-19413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/113Journal of Nara Medical Association, 54(3): 189-194http://hdl.handle.net/10564/113http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/113/1/189-194p.%e8%b6%85%e9%9f%b3%e6%b3%a2%e6%96%ad%e5%b1%a4%e6%a4%9c%e6%9f%bb%e3%81%a7%e5%81%b6%e7%84%b6%e7%99%ba%e8%a6%8b%e3%81%95%e3%82%8c%e3%81%9f%e8%83%83%e3%81%ae%e6%9c%89%e8%8c%8e%e6%80%a7%e5%a3%81%e5%a4%96%e7%99%ba%e8%82%b2%e5%9e%8bGastrointertinal_stromal_tumor%28GIST%29%e3%81%ae1%e4%be%8b%ef%bc%88%e8%be%b0%e5%b7%b3%e6%ba%80%e4%bf%8a%e3%81%bb%e3%81%8b%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5431891942003-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1142017-05-29T06:07:07Zhdl_10564_1558表紙、目次、投稿規程、奥付(Vol.54 No.4)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.54 No.413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/114Journal of Nara Medical Association, 54(4)http://hdl.handle.net/10564/114http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/114/1/000p.%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5442003-08-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1152017-05-29T06:06:49Zhdl_10564_1558シェーグレイ症候群を診る藤本, 隆Sjögren's syndromeetiologyautoimmune diseaseinterstitial nephritisrenal tubular acidosisシェーグレン症候群は,1933年にSjögrenにより原因不明の乾燥性角結膜炎と耳下腺腫脹を合併するリウマチ性疾患と報告されたのを端緒とする。本症候群は,涙腺や唾液腺などの外分泌腺に限局した臓器特異的自己免疫疾患を特徴とするが,同時に問質性腎炎・問質性肺炎・
原発性胆汁性肝硬変症などの系統的自己免疫疾患を随伴することが少なくない。その発症には何らかの免疫異常が誘発されることが引き金になるものと考えられるが,その機構は解明されていない。現在,本症の病因に関連する自己抗原の同定・標的臓器における腺破壊の機序・自己反応性T細胞の制御などに関して研究が進められている。本稿では本症の診断・発症機序・多彩な臓器病変について概説したい。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.54 No.4 p.195-20613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/115Journal of Nara Medical Association, 54(4): 195-206http://hdl.handle.net/10564/115http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/115/1/195-206p.%e3%82%b7%e3%82%a7%e3%83%bc%e3%82%b0%e3%83%ac%e3%82%a4%e7%97%87%e5%80%99%e7%be%a4%e3%82%92%e8%a8%ba%e3%82%8b%ef%bc%88%e8%97%a4%e6%9c%ac%e9%9a%86%ef%bc%89.pdf13450069AA11252383Journal of Nara Medical Association5441952062003-08-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1162017-05-29T06:06:49Zhdl_10564_1568血清脂質濃度と脂質関連栄養素摂取量との関連CORRELATIONS BETWEEN SERUM LIPIDS AND INTAKE OF FAT-RELATED NUTRIENTS石塚, 理香天野, 信子岡本, 希森田, 徳子佐伯, 圭吾車谷, 典男serum lipidscross-sectional studyintakes of fatty acidsfood frequency questionnaireThe correlations of the intake of the following nutrients to the serum levels of total cholesterol (TCH), high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, and triglyceride (TG) were investigated in 249 female subjects (aged 55.3 ± 6.0) who participated in our intervention study aiming at decreasing the TCH: energy, protein, carbohydrate, lipid, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol. Daily intakes of various nutrients were estimated in face-to-face interviews by a dietitian trained for the purpose and also using a food frequency questionnaire with dedicated computer software. The TCH, LDL and TG increased with age, while the serum HDL decreased with age. According to the multiple regression analysis conducted taking the serum lipids as dependent variables and intake of various nutrients, including energy intake and age as independent variables, there were no significant independent variables for HDL or TG, and age alone β=0.15) was significant (p<0.05) for TCH. Intake of saturated fatty acids (β=0.15) was a significant independent variable (p<0.05) in addition to age (β=0.18, p<0.01) for LDL, but the total contribution of the intake of saturated fatty acids was 4% lower. The present study suggests that the intake of fat-related nutrients can hardly be estimated from the serum concentrations of lipids such as TCH.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.1-713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/116Journal of Nara Medical Association, 56(1): 1-7http://hdl.handle.net/10564/116http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/116/1/KJ00004166111.pdf13450069AA11252383Journal of Nara Medical Association561172005-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1172017-06-07T16:30:06Zhdl_10564_1568表紙、目次、投稿規程、奥付(Vol.56 No.1)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.56 No.113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/117Journal of Nara Medical Association, 56(1)http://hdl.handle.net/10564/117http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/117/1/Vol.56%281%29%ef%bc%9b%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5612005-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1182017-05-29T06:07:05Zhdl_10564_1568EXPRESSION OF HEAT-SHOCK PROTEIN 70 IN CORNEAS AFTER LASER IN SITU KERATOMILEUSIS (LASIK)Okada, YasushiNawa, YoshiakiHara, YoshiakiHSP 70LASIKcorneaWe investigated the expression of heat shock protein (HSP) 70 in rabbit corneas after laser in situ keratomileusis (LASIK). Pathological examination was performed immediately after LASIK and at one month after the surgery. The superficial corneal stroma was markedly stained with anti-HSP 70 antibody immediately after LASIK. At one month after the surgery the cornea was not positively stained. The clinical relevance of this experimental result is discussed.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.9-1313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/118Journal of Nara Medical Association, 56(1): 9-13http://hdl.handle.net/10564/118http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/118/1/KJ00004166112.pdf13450069AA11252383Journal of Nara Medical Association5619132005-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1192017-05-29T06:06:49Zhdl_10564_1568奈良県立医科大学精神科児童思春期外来における最近の患者動向についてTRENDS OF RECENT CHILD AND ADOLESCENT PSYCHIATRIC PRACTICE AT THE DEPARTMENT OF PSYCHIATRY, NARA MEDICAL UNIVERSITY岸野, 加苗姜, 昌勲根來, 秀樹高橋, 弘幸澤田, 将幸太田, 豊作岸本, 年史岩坂, 英巳飯田, 順三child and adolescent psychiatryDSM-IVoutpatientWe investigated outpatients younger than 19 years old who first visited the psychiatric serviceat Nara Medical University Hospital in 2003. The total number of new outpatients under 19 years old in 2003 was 210. Of all patients, 188 patients were investigated by clinical charts. About 32% of the patients were referred by psychiatrists in other psychiatric services. Patients diagnosed with Adjustment disorders and patients diagnosed with Neurotic disorders were most of all patients. We also investigated outcomes.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.15-2113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/119Journal of Nara Medical Association, 56(1): 15-21http://hdl.handle.net/10564/119http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/119/1/KJ00004166113.pdf13450069AA11252383Journal of Nara Medical Association56115212005-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1202017-05-29T06:06:49Zhdl_10564_1568東大阪市療育センター児童精神科における外来診療統計A REPORT OF OUTPATIENTS AT THE PSYCHIATRIC PSHICHIATRIC SERVICE OF HIGASHIOSAKA CITY REHABILITATION CENTER FOR CHILDREN WITH DISABILITIES岸野, 加苗飯田, 順三根來, 秀樹姜, 昌勲橋本, 和典岸本, 年史childrendisabilityoutpatientPervasive Developmental DisordersRehabilitation Center for ChildrenWe report the data of outpatients who presented at the Higashiosaka City Rehabilitation Center for Children with Disabilities for the first medical examination from April 2002 to March 2004. The total number of outpatients was 207 cases, of which cases (93%)were referred from other institutions. Especially 116 cases (56%) were referred from the health check system at public health centers. 94cases (46%) were diagnosed as Pervasive Developmental Disorders. There were 9 pairs of siblings diagnosed with some disabilities. More comprehensive studies about acceptance of disabilities bv careedvers are needed.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.23-3013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/120Journal of Nara Medical Association, 56(1): 23-30http://hdl.handle.net/10564/120http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/120/1/KJ00004166114.pdf13450069AA11252383Journal of Nara Medical Association56123302005-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1212017-05-29T06:09:10Zhdl_10564_1568ANTIBIOTIC PROPHYLAXIS FOR TRANSRECTAL NEEDLE BIOPSY OF THE PROSTATEHosokawa, YukinariKishino, TatsukiOno, TakamasaOyama, NobuoMomose, Hitoshiprostate biopsyinfectionprostate carcinomaObjectives: Transrectal needle biopsy of the prostate is essential for the diagnosis of prostate carcinoma, but there is no unanimity of opinion on the antibiotic prophylaxis for that procedure. This study was designed to explore appropriate prophylactic antimicrobial regimens. Methods: Sixty patients undergoing prostate biopsy were assessed for any overt febrile infection. In the first 30 cases constituting Group 1, ceftibuten (CETB) was administered orally at 200 mg b.i.d. for 3 days, beginning on the day of biopsy, which was also the day of admission (2-3 hours before biopsy). As no serious adverse events were seen among those patients, CETB was administered at 200 mg b.i.d. orally for only one day, the day of admission, in the latter 30 cases (Group 2), and the clinical responses of the groups were compared. Results: None developed a fever post-biopsy in Group 1, while there were 2 patients (6.7%) who developed a fever at >38° C in Group 2. There was no statistically significant intergroup difference in incidence of fever. Conclusions: The prophylactic antibiotic regimens administered in Groups 1 and 2 were considered to be comparable in efficacy.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.31-3613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/121Journal of Nara Medical Association, 56(1): 31-36http://hdl.handle.net/10564/121http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/121/1/KJ00004166115.pdf13450069AA11252383Journal of Nara Medical Association56131362005-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1222020-09-30T04:29:17Zhdl_10564_1568RADICULOMYELOPATHY DUE TO TUMORAL CALCIFICATION OF THE LIGAMENTUM FLAVUM OF THE CERVICAL SPINENanase, HiroyukiPark, Young-SuShin, YasushiSakai, ToshisukeGoda, KazuoAoyama, Nobufusacervical spinecalcificationligamentum flavumA case of a 68-year-old woman with radiculomyelopathy caused by unilateral tumoral calcification of the ligamentum flavum of the cervical spine is reported. The patient developed the left shoulder pain and tetraparesis in the previous two years, and the symptoms has deteriorated in spite of conservative therapy. Neurological examination revealed motor weakness, hyperreflexia and hypesthesia in the four extremities. Neuroradiologically, a unilateral nodular opacification was shown in the left C4-C5 level. CT scan revealed nodular calcification, and MRI showed marked compression of the cervical cord by the calcified mass. Removal of the calcification through the left hemilaminectomy was performed using ultrasonic bone curettage. Light microscopic examination showed calcified deposits in the ligamentum flavum without crystals of calcium pyrophosphate dihydrate (CPPD). The patient was discharged from the hospital with improvement of the neurological symptoms奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.37-4213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/122Journal of Nara Medical Association, 56(1): 37-42http://hdl.handle.net/10564/122http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/122/1/KJ00004166116.pdf13450069AA11252383Journal of Nara Medical Association56137422005-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1232020-09-30T04:27:47Zhdl_10564_1568DYSPHAGIA CAUSED BY ANTERIOR CERVICAL OSTEOPHYTESNakase, HiroyukiShin, YasushiPark, Young-SuSakaki, Toshisukedysphagiacervical spinehyperosteosisAlthough cervical spondylosis is a common disorder, dysphagia induced by osteophyte formation is uncommon. Reports in the literature show that vertebral hypertrophic spurs causing dysphagia result from bony degeneration or idiopathic causes (diffuse idiopathic skeletal hyperosteosis: DISH) (Forestier's disease). We present a case suffering dysphagia secondary to cervical osteophytes. A 62-year-old male patient presented with a complaint of dysphagia. Physical examination showed no abnormality. A cervical X-ray and computed tomography (CT) showed a large bone spur originating from the anterior surface of the C3/4. Barium esophagography revealed osteophytic spurs in the anterior aspect of C3/4 vertebrae, in close approximation to the inlet of the esophagus, obstructing the esophagus passage by external compression. Anti-inflammatory therapy administered did not provide relief of the patient's complaint. Functional improvement was immediate after surgical removal of the osteophyte using ultrasonic bone curettage via an anterior cervical approach. Surgery is mandatory if medical care fails and dysphagia is complete.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.43-4813450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/123Journal of Nara Medical Association, 56(1): 43-48http://hdl.handle.net/10564/123http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/123/1/KJ00004166117.pdf13450069AA11252383Journal of Nara Medical Association56143482005-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1242020-09-30T04:29:46Zhdl_10564_1568SPINAL EXTRADURAL ARACHNOID CYST IN THE THORACICKim, Yeong-JinNakase, HiroyukiPark, Young-SuShin, YasushiSakaki, Toshisukespineextradural arachnoid cystthoracicSpinal extradural arachnoid cysts are relatively rare, and the pathogenesis is still unclear. Here, we report a case with a Type I-A lesion by Nabors' classification (extradural arachnoid cyst without spinal nerve root fiber involvements) treated surgically. A 38-year-old female patient presented with a complaint of low back pain and bilateral hypesthesia of the legs. Physical examination showed no abnormality. Magnetic resonance imaging (MRI) showed an extradural cerebrospinal fluid (CSF)-containing lesion without involvement of the posterior epidural fat at Thll-Ll. CT with bone algorithms revealed bone erosion with widening of the canal, foraminal enlargement and scalloping of the vertebral body. Resection of the cyst wall and closure of the ostium were easily performed. This procedure resulted in the relief of her symptoms. Postoperative MRI demonstrated that both the cystic lesion and nerve root compression had disappeared. Histological examination showed clusters of meningothelial cells, which are a typical feature of arachnoid cysts. Radical cyst removal and dura defect closure are the surgical intervention of choice in patients with symptomatic extradural arachnoid cyst.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.49-5313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/124Journal of Nara Medical Association, 56(1): 49-53http://hdl.handle.net/10564/124http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/124/1/KJ00004166118.pdf13450069AA11252383Journal of Nara Medical Association56149532005-02-28engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1252019-10-31T06:09:44Zhdl_10564_1568稀な原因による脊髄空洞症の3例THREE CASES OF SYRINGOMYELIA DUE TO UNUSUAL CAUSES朴, 永銖木村, 僚太中瀬, 裕之榊, 壽右syrigomyeliacervical spondylosisadhesive arachnoiditistuberculous meningitisIn many cases, syringomyelia is associated with Chiari malformation and spinal cord tumor. We report three cases of syringomyelia due to unusual causes. [Case 1] 64 years old, a woman. She had painful numbness and weakness of the right hand. MRI showed broad syringomyelia, which extended from C2 to Th2 and severe spinal cord compression at C6/7 level derived from spondylotic spur formation. Dynamic cervical X-ray revealed mild anterior sliding at C4/5. We performed anterior decompression and fusion with titanium cylindrical cages for two segments (C4/5 and C6/7). Since syrinx had regressed three months later on MRI, we suspected that dynamic cervical movement had gradually caused syringomyelia. [Case 2] 61 years old, a man. He had suffered bilateral leg numbness and gait difficulty for several years. On MRI examination, intramedullary cystic mass and syrigomyelia were detected at thoracic spine. In operation, thickened and turbid arachnoid membrane was widely dissected and free cerebrospinal fluid collection pathway was preserved after duroplasty with fascia. Syrinx regressed on MRI after three months, so we diagnosed syrigomyelia due to idiopathic adhesive arachnoiditis. [Case 3] 73 years old, a man. Over 40 years before, he was surgically treated for thoracic vertebral caries. He had gradually developed gait disturbance and paraparesis for several years. MRI revealed intramedullary cyst (syrinx formation) at ThlO. Concurrently meningeal thickening was found. We judged that syringomyelia occurred as a late complication of tuberculous meningitis. Unfortunately our surgical procedure, syringostomy and dissection of arachnoid membrane, did not improve his deficits.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.1 p.55-6013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/125Journal of Nara Medical Association, 56(1): 55-60http://hdl.handle.net/10564/125http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/125/1/KJ00004166119.pdf13450069AA11252383Journal of Nara Medical Association56155602005-02-28jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1262017-06-11T23:20:26Zhdl_10564_1570表紙、目次、投稿規程、奥付(Vol.56 No.2)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.56 No.213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/126Journal of Nara Medical Association, 56(2)http://hdl.handle.net/10564/126http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/126/1/Vol.56%282%29_%ef%bc%9b_%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5622005-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1272017-05-29T06:07:05Zhdl_10564_1570奈良県立医科大学附属病院における感染症対策INFECTION CONTROL IN NARA MEDICAL UNIVERSITY三笠, 桂一古西, 満善本, 英一郎笠原, 敬宇野, 健司村川, 幸市小泉, 章岡本, 康幸前田, 光一喜多, 英一徳谷, 純子山添, 雅之ICCICTInfection control奈良県立医科大学附属病院では,2001年6月に新しい病院感染対策のための組織を構築し,感染対策チーム(ICT)による病棟ラウンドの開始やMRSA届出制度の開始などさまざまな感染症対策を実施し成果をあげてきた。また,2003年には第1種感染症指定医療機関に指定され,今後の感染症対策の充実が大きな課題である。一方,バイオテロ発生の懸念やSARSの再流行,また新型インフルエンザのパンデミックの懸念や耐性菌の増加あるいはAIDSの増加など,最近の感染症を取り巻く状況はめまぐるしく変化している。我々に求められるのは奈良県全体の感染症対策の向上であり安全で良質な感染症医療の提供である。本院における感染症対策の一部を紹介する。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.2 p.61-6713450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/127Journal of Nara Medical Association, 56(2): 61-67http://hdl.handle.net/10564/127http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/127/1/KJ00004166127.pdf13450069AA11252383Journal of Nara Medical Association56261672005-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1282017-05-29T06:07:05Zhdl_10564_1570AUTOPHAGY IN SKELETAL MUSCLE : AUTOPHAGIC VACUOLAR MYOPATHIESSugie, KazumaUeno, Satoshiautophagyautophagic vacuolelysosomeDanon diseaserimmed vacuoleEukaryotic cells from yeast to human primarily use two distinct major mechanism for intracellular degradation/recycling system: the autophagy and proteasome. Autophagy contributes to the turnover of cellular components by delivering portions of the cytoplasm and organelles to lysosomes, where they are digested. Moreover, autophagy is involved in programmed cell death (PCD) and is called type II PCD, which differs from apoptosis (type I PCD). By mostly morphological studies, autophagy has been linked to disease processes: cancer, liver diseases, neurodegeneration, muscular disorders, and so on. Actually, lysosomes or autophagic vacuoles are morphologically unremarkable in normal muscle. However, in certain muscular disorders, the lysosomal system becomes prominent, indicating that autophagy is essential for muscle fibers. Here, we described current knowledge about the role of autophagy and the autophagy in muscular disorders: autophagic vacuolar myopathies.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.2 p.69-8013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/128Journal of Nara Medical Association, 56(2): 69-80http://hdl.handle.net/10564/128http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/128/1/KJ00004166128.pdf13450069AA11252383Journal of Nara Medical Association56269802005-04-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1292017-05-29T06:07:15Zhdl_10564_1570医学教育論 教育原理,成人教育学,専門家(プロフェショナル)教育理論より医学教育を考えるMEDICAL EDUCATION BASED ON EDUCATION THEORY, ADULT EDUCATION AND PROFESSIONAL EDUCATION森田, 孝夫education theoryadult educationprofessional education日本の医学教育は従来,時間制で全科目必修であったが,現在は原則単校訓で科目の改変再編が顕著に進み,基礎・社会・臨床医学のみならず教養科目との統合(インテグレーション)が進行している。また,新しい教育原理や成人教育学理論に基づいて,教授方法も講義から少人数チュートリアルなどによる問題基盤型学習(PBL-tutorial)へ,また,プロフェショナル教育理論に基づいて,臨床実習も見学型から診療参加型のクリニカル・クラークシップヘと移行しつつある。また,個々の大学の多様性を盛り込んだ特色あるカリキュラムの採用が進んでいる。このような変革の時代にあって,改革の方向を正しく見据えて対処するためには,教育改革の根底にある教育理論を理解することが重要と考えられる。現在進行している教育改革を教育原理,成人教育学,専門家教育論などの教育理論から概説する。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.2 p.81-9013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/129Journal of Nara Medical Association, 56(2): 81-90http://hdl.handle.net/10564/129http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/129/1/KJ00004166129.pdf13450069AA11252383Journal of Nara Medical Association56281902005-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1302017-05-29T06:07:05Zhdl_10564_1570奈良県立医科大学附属病院精神科における2000年度の新入院・外来患者臨床統計NOSOLOGICAL DATUM ON OUTPATIENTS AND INPATIENTS IN DEPARTMENT OF PSYCHIATRIC SERVICE IN NARA MEDICAL UNIVERSITY HOSPITAL IN FISCAL 2000木内, 邦明森川, 将行洪, 基朝池下, 克実飯田, 順三大澤, 弘吉猪原, 淳法山, 良信平山, 智英根來, 秀樹扇谷, 嘉成徳山, 明広金, 英浩五十嵐, 潤根本, 隆哉高橋, 弘幸中田, 正樹林, 竜也横山, 敬輝橋本, 和典岸本, 年史ICD-10psychiatric servicenosologyNosological data on outpatients and inpatients in the Psychiatric Service of Nara Medical University Hospital in fiscal 2000, are reported in this paper. The total of outpatients were 928 cases and inpatients were 219 cases. According to the diagnostic classification using F codes of the ICD-10, F4 (neurotic, stress-related and somatoform disorder) were most frequent (247 cases, 26.6%) of the outpatients, followed by F3 (mood disorder ; 218 cases, 23.5%), F2 (schizophrenia schizotypal and delusional disorder ; 121cases, 13%) and others. On the other hand , F3 (mood disorder) were most frequent ( 68cases, 31.1% ) of the inpatients, followed by F2 (schizophrenia schizotypal and delusional disorder; 55 cases, 25.1%), F4 (neurotic, stress-related and somatoform disorder; 40 cases, 18.3%) and others.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.2 p.91-9513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/130Journal of Nara Medical Association, 56(2): 91-95http://hdl.handle.net/10564/130http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/130/1/KJ00004166130.pdf13450069AA11252383Journal of Nara Medical Association56291952005-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1312017-05-29T06:07:15Zhdl_10564_1570NEPHROGENIC DIABETES INSIPIDUS WITH A V2 RECEPTOR MUTATION AT A FUNCTIONALLY CRITICAL SITENishikubo, ToshiyaKisato, YorikoIshikawa, NaokoKuwahara, IsaoKamitsuji, HidekazuYoshizato, KazuakiAraki, Eiichiinfantnephrogenic diabetesinsipidusvasopressin type 2 receptor gene mutationWe present an infant with congenital nephrogenic diabetes insipidus with a V2 receptor mutation. The infant was admitted to our hospital because of high fever 7 days after birth. Laboratory examinations demonstrated elevated serum sodium (152 mEq/L) and chloride (113mEq/L) concentrations. Plasma osmolarity was increased to 312 mOsm/kg, even though urinary osmolarity was 76 mOsm/kg. Serum AVP concentration was markedly increased. Pitressin-loading test did not show marked increment in the urinary osmolarity or secretion of urinary cyclic-AMP. Therefore, the patient was clinically diagnosed as having nephrogenic diabetes insipidus. DNA analysis of the V2 receptor gene identified a C to A transition at nucleotide position 1503. This mutation leads to a predictable change from Proline to Histidine. The patient was fed a sodium-restricted formula and administered trichlormethiazide. After initiating treatment, the serum concentration of Na was maintained below 150 mEq/L, and there was no physical dysfunction or mental retardation. Early diagnosis followed by early interventions was important to improve the prognosis.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.2 p.97-10313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/131Journal of Nara Medical Association, 56(2): 97-103http://hdl.handle.net/10564/131http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/131/1/KJ00004166131.pdf13450069AA11252383Journal of Nara Medical Association562971032005-04-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1322017-05-29T06:07:05Zhdl_10564_1570化学放射線療法後に原発腫瘍とリンパ節転移に石灰化をきたした頚部食道癌の1例A CASE OF CERVICAL ESOPHAGEAL CANCER WITH ACCUMULATED CALCIFICATION IN THE PRIMARY TUMOR AND LYMPH NODE METASTASIS AFTER CHEMORADIOTHERAPY玉本, 哲郎吉村, 均浅川, 勇雄藤本, 正男福井, 博家根, 旦有高, 済峯松尾, 祥弘城根, 憲esophageal cancerchemoradiotherapycalcificationA 68-year-old woman with neck swelling and dysphagia presented at our hospital in February of 2002. In CT findings, a tumor invading the trachea and cervical lymph node metastasis (LN met) were found. No distant metastasis was observed. Therefore, we diagnosed cervical esophageal cancer (T4N3MO: stage IVa) clinically, and performed chemoradiotherapy concurrently. Radiotherapy was performed by a 4 MV linear accelerator, at a total dose of 60 Gy with a fraction of 2 Gy per day. Chemotherapy was administered as 2 cycles of cisplatin (CDDP) at 6 mg/m^2/day and 5-fluorouracil (5-Fu) at 300 mg/m^2/day (day 1-5, 8-12). After these treatments, the tumors reduced markedly and calcifications could be detected in the esophageal tumor and LN mets in CT. However, a few months later, mediastinal LN met was found, so we again performed chemoradiotherapy. Radiotherapy was performed by a 10 MV linear accelerator, at a total dose of 30 Gy with a fraction of 2 Gy per day. Chemotherapy was administered as 1 cycle of CDDP at 10 mg/day and 5~Fu at 500 mg/day (day 1-5, 8-12). After this treatment, additional chemotherapy was administered as 1 cycle of nedaplatin at 10 mg/day and 5-Fu at 500 mg/day (day 1-5, 8-12). About 10 months after the first treatment, the primary tumor grew again and the dysphagia worsened. Finally, the patient died of hemorrage due to the local tumor. We report here a rare case of calcification in presumed esophageal cancer after radiotherapy. This case suggests that the tumor calcification is a marked tumor response after chemoradiotherapy.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.2 p.105-11013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/132Journal of Nara Medical Association, 56(2): 105-110http://hdl.handle.net/10564/132http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/132/1/KJ00004166132.pdf13450069AA11252383Journal of Nara Medical Association5621051102005-04-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1332017-06-11T23:20:26Zhdl_10564_1571表紙、目次、投稿規程、奥付(Vol.56 No.3)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.56 No.313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/133Journal of Nara Medical Association, 56(3)http://hdl.handle.net/10564/133http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/133/1/Vol.56%283%29_%ef%bc%9b_%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5632005-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1342017-05-29T06:07:05Zhdl_10564_1571新生児エアリーク症例の臨床的検討CLINICAL ANALYSIS OF PULMONARY AIR LEAKS IN NEONATES辰巳, 公平西和田, 忠釜本, 智之坂東, 由香西久保, 敏也西野, 正人air leakneonatepneumothoraxrespiratory distress syndromemeconium aspiration syndromeWe retrospectively analyzed the characteristics of infants complicated with pulmonary air leaks admitted to the neonatal intensive care unit. Forty infants with pulmonary air leaks were admitted to our neonatal intensive care unit between 1995 and 2004. The mean gestational ages and birth weights were 36.7 ± 5.6 weeks and 2488 ± 942g, respectively. The number and subtypes of air leaks were as follows: pneumothorax 29 (64%), pneumothorax and pneumomediastinum 5 (11%), pneumomediastinum 4 (9%), pneumopericardium 1 (2.5%) and pulmonary interstitial emphysema 1 (2.5%). Thirty-six (90%) infants developed air leaks within 24 hours after birth. The underlying diseases causing air leaks were transient tachypnea of the newborn (26%), meconium aspiration syndrome (17%), respiratory distress syndrome (15%), and so on. Eight infants (17%) were diagnosed as having spontaneous pneumothorax. Nine cases (22.5%) were very low birth weight infants. Premature infants tend to develop air leaks with respiratory distress syndrome, and term infants tend to develop air leaks with meconium asipiration syndrome. Four infants (10%) developed air leaks while on mechanical ventilators. For treatment, all infants required oxygen administration, and 9 infants improved spontaneously. Pleuracentesis was conducted in 8 infants, and 6 infants required continuous air drainage after pleuracentesis. Mechanical ventilation including nasal CPAP was performed in 23 infants. Intraventricular hemorrhage, which is known as a major complication of pulmonary air leaks, occurred in 3 infants (7.5%). Four infants (10%) died of the underlying diseases, and 36 infants survived without complications. It is important to consider the presence of air leaks in patients with respiratory abnormalities, and emergent treatments are necessary to prevent complications including intraventricular hemorrhage.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.3 p.111-11913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/134Journal of Nara Medical Association, 56(3): 111-119http://hdl.handle.net/10564/134http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/134/1/KJ00004166140.pdf13450069AA11252383Journal of Nara Medical Association5631111192005-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1352017-05-29T06:06:33Zhdl_10564_1571上腹部手術既往を有する患者に対する腹腔鏡下胆嚢摘出術の検討LAPAROSCOPIC CHOLECYSTECTOMY FOR PATIENTS WHO HAD PREVIOUS UPPER ABDOMINAL SURGERY明石, 論山本, 雅敏三和, 武史細井, 考純今川, 敦史八倉, 萬之助laparoscopic cholecystectomyprevious upper abdominal surgeryLaparoscopic cholecystectomy (LC) was widely accepted as a treatment for gall bladder disease. In the early days of this procedure, previous upper abdominal surgery was a relative contraindication to LC. However, some studies reported that an indication for LC extended to these patients. To assess the feasibility of LC for patients who had previous upper abdominal surgery, we retrospectively analyzed our cases. Between January 1998 and November 2000, 217 patients with gall bladder disease were considered as candidates for cholecystectomy. Patients were divided into three groups (Group A: LC for patients with no abdominal surgery or lower abdominal surgery, Group B: LC for patients with upper abdominal surgery, Group C: Open cholecystectomy (OC) for patients with upper abdominal surgery) and compared with regard to operation time, removal of nasogastric tube, start of oral intake and postoperative hospitalization. There were no statistically significant differences in operation time within the three groups. As for removal of nasogastric tube, start of oral intake and postoperative hospitalization, group B was significantly earlier than group C. If patients are selected carefully, LC will be a useful procedure for patients who had previous upper abdominal surgery.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.3 p.121-12613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/135Journal of Nara Medical Association, 56(3): 121-126http://hdl.handle.net/10564/135http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/135/1/KJ00004166141.pdf13450069AA11252383Journal of Nara Medical Association5631211262005-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1362017-05-29T06:07:05Zhdl_10564_1571EVENT-RELATED POTENTIALS IN ADULTS WITH ATTENTION DEFICIT / HYPERACTIVITY DISORDER (AD/HD)Negoro, HidekiKyo, MasanoriOnishi, TakakoKishimoto, ToshifumiIwasaka, HidemiIida, Junzoadult attention deficithyperactivity disorder (adult AD/HD)event-related potential (ERP)P300negative difference (Nd)mismatch negativity (MMN)Objective: A specific disorder at the stage of cognition and/or information processing might be involved in attention deficit/hyperactivity disorder (AD/HD). We measured negative difference (Nd) and mismatch negativity (MMN), the early negative components which reflect the attention function, in addition to P300. In earlier studies we examined these ERPs in children with AD/HD. In the present study, we examine the attentive and cognitive disturbances associated with adult AD/HD, measuring the auditory Nde, MMN, and P300. Method: 15 adults with DSM-IV-diagnosed AD/HD and 15 healthy control subjects were studied. Result: P300 and early Nd (Nde) amplitudes were smaller in the adult AD/HD group as compared with the healthy control group. Conclusions: When performing selective attention tasks, the same specific disturbances in the active stimulus selection process and the selective attention maintenance process occur in adults with AD/HD as in children with AD/HD.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.3 p.127-13513450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/136Journal of Nara Medical Association, 56(3): 127-135http://hdl.handle.net/10564/136http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/136/1/KJ00004166142.pdf13450069AA11252383Journal of Nara Medical Association5631271352005-06-30engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1372017-05-29T06:06:33Zhdl_10564_1571胃内腔へ浸潤した後腹膜原発平滑筋肉腫および平滑筋芽腫の1剖検例RETROPERITONEAL LEIOMYOSARCOMA AND LEIOMYOBLASTOMA DIRECTLY INVADED THE STOMACH AN AUTOPSY CASE REPORT守屋, 圭増井, 一弘前川, 泰寛山根, 佳子豊川, 泰勲明石, 陽介永松, 晋作中谷, 敏也菊池, 英亮山田, 高嗣仲川, 昌之渡辺, 明彦吉岡, 哲也中西, 啓介leiomyosarcomaleiomyoblastomaretroperitoneumdigestive perforationA 70-year-old woman complaining of nausea was admitted to our hospital for further examination of a large abdominal tumor. CT scan, MRI and Ultrasonography revealed a large mass adjacent to the left kidney, spleen and pancreas. Angiography showed a tumor stain mainly fed by the dorsal pancreatic artery. Although radical tumorectomy as well as splenectomy was performed, complete removal of the tumor was not successful because of the marked adhesion that easily caused critical bleeding by surgical manipulation. In addition, 2 kinds of chemotherapy conducted after surgical treatment showed little efficacy, resulting in the rapid growth of the locally recurrent lesion. Finally, the formation of tumor thrombus in the inferior vena cava was followed by its direct invasion to the stomach with severe ulceration causing refractory bleeding. Consequently, she died of multiple organ failure caused by repeated upper gastrointestinal bleeding. Autopsy revealed a retroperitoneal tumor consisting of leiomyosarcoma as well as leiomyoblastoma with pathologically high malignancy.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.3 p.137-14613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/137Journal of Nara Medical Association, 56(3): 137-146http://hdl.handle.net/10564/137http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/137/1/KJ00004166143.pdf13450069AA11252383Journal of Nara Medical Association5631371462005-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1382017-05-29T06:07:05Zhdl_10564_1571無症候性蛋白尿/血尿で発見された膜性増殖性糸球体腎炎5症例の臨床的検討CLINICAL ANALYSIS OF 5 CASES OF ASYMPTOMATIC MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS村上, 智彦上辻, 秀和中野, 智巳金, 一asymptomatic hematuriaasymptomatic proteinuriaMPGNfocal MPGNWe analyzed the clinical features and prognoses of 5 cases of asymptomatic membranoproliferative glomerulonephritis(MPGN). Two boys and 3 girls were noticed with chance hematuria and/or proteinuria on the mass urine screening system in schools and all presented with persistent hypocomplementemia. Three of them showed typical MPGN form but 2 cases showed an atypical form, focal thickening of basement membrane and double track in light microscopy. All patients were treated with steroid and anticoagulant therapy. Urinary findings improved in 4 cases from 5 months to 8 years after treatment and serum complement was normalized in 3 cases from 10 to 27 months. Rebiopsy was performed in 4 cases and the histological findings were not advanced in all cases but improved in 3 cases. We considered that early detection and treatment may improve the clinical course and prognosis of asymptomatic cases of MPGN.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.3 p.147-15313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/138Journal of Nara Medical Association, 56(3): 147-153http://hdl.handle.net/10564/138http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/138/1/KJ00004166144.pdf13450069AA11252383Journal of Nara Medical Association5631471532005-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1392017-05-29T06:06:34Zhdl_10564_1571腹腔鏡下脾温存膵体尾部切除術を施行した膵Solid-pseudopapillary tumorの1例A CASE OF LAPAROSCOPIC DISTAL PANCREATECTOMY WITH PRESERVATION OF THE SPLEEN FOR SOLID-PSEUDOPAPILLARY TUMOR明石, 論山本, 雅敏三和, 武史細井, 孝純今川, 敦史八倉, 萬之助laparoscopic distal pancreatectomypreservation of the spleensolid-pseudopapillary tumorA 27-year-old woman was admitted to our hospital because of urinary urgency. Abdominal US demonstrated a large tumor measuring 7cm in diameter, located in the body to tail of the pancreas. It was diagnosed as solid-pseudopapillary tumor by preoperative radiological examinations including CT, MRI and angiography. Laparoscopic distal pancreatectomy with preservation of the spleen was performed. Resected specimen was removed through a 9cm-lengthed lateral incision. The operation time was 354 minutes and blood loss was 345ml. Some complications occurred in the postoperative state, but use of analgesic medication was required once only. She was discharged on the 25th postoperative day. Laparoscopic procedure is less invasive than conventional open surgery, and has a cosmetic advantage. Distal pancreatectomy does not require the reconstruction of the gastro-intestinal tract ; this procedure can be recommended for benign or low grade malignant pancreatic disease.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.3 p.155-16113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/139Journal of Nara Medical Association, 56(3): 155-161http://hdl.handle.net/10564/139http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/139/1/KJ00004166145.pdf13450069AA11252383Journal of Nara Medical Association5631551612005-06-30jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1402017-06-11T23:20:26Zhdl_10564_1572表紙、目次、投稿規程、奥付(Vol.56 No.4)表紙目次投稿規程奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.56 No.413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/140Journal of Nara Medical Association, 56(4)http://hdl.handle.net/10564/140http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/140/1/Vol.56%284%29_%ef%bc%9b_%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%e7%a8%8b%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association5642005-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1412017-05-29T06:06:33Zhdl_10564_1572抗酸化薬の動脈硬化予防効果 : in vitroでのebselenの作用とin vivoでの経口亜硝酸の作用ATHEROPROTECTIVE EFFECTS OF ANTIOXIDANTS-IN VITRO EFFECT OF EBSELEN AND IN VIVO EFFECT OF ORALLY ADMINISTERED NITRITE吉栖, 正典oxidative stressantioxidantsMAP kinaseebselennitrite近年の細胞内情報伝達研究や分子生物学研究の発展によって,酸化ストレスが様々な疾病の病態生理に深く関わっていることが明らかになってきた。たとえば高血圧,糖尿病,癌,動脈硬化などの発症や進展に酸化ストレスが関与しているという報告がある。一方で,抗酸化作用を持つ薬物が動脈硬化の進展抑制に効果があるという報告もあるが,その成績の多くは臨床的に満足のいくものではない。本総説では,酸化ストレスによる動脈硬化発症・進展の細胞内情報伝達機構について概説し,抗酸化薬としてのebselen (エブセレン)のin vitroでの効果と経口亜硝酸投与のin vivoでの効果を解説する。さらに,動脈硬化予防薬としての抗酸化薬の現状での問題点と今後の可能性について述べる。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.4 p.163-17313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/141Journal of Nara Medical Association, 56(4): 163-173http://hdl.handle.net/10564/141http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/141/1/KJ00004166154.pdf13450069AA11252383Journal of Nara Medical Association5641631732005-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1422017-05-29T06:07:05Zhdl_10564_1572カウンセリングをいかした院内学級の取り組みCOUNSELING-ORIENTED EDUCATION FOR HOSPITALIZED JUNIOR RIGHT SCHOOL STUDENTS阪中, 順子hospitasl classcooperation between medicine and educationcounselingterminal carestudent support院内学級は,入院中の児童生徒を対象に学習活動を保障する「病院の中の学校」である。奈良医大附属病院院内学級担任として取り組んだカウンセリングを生かした教育実践の概要について報告する。小児がんなどの難病に苦しむ生徒や深刻な心の問題を抱えた生徒に対して,心のケアをぬきに学習指導を行うことはできない。本稿では小児がんのA子の事例を取りあげた。1回目の入院では,地元校へのスムーズな復帰を目標に,2回目の入院では,再発に対する不安の軽減をサポートすることを目標においた。この事例を通して,入院中の児童生徒たちによりよい教育を提供するために,教員自身が平素から生や死の問題を真摯に考え学ぶこと,教員として自らのできることとできないことを自覚すること,医療と教育の専門職同士がお互いを尊重しつつ密接な連携をとることの重変性について考察した。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.4 p.175-18113450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/142Journal of Nara Medical Association, 56(4): 175-181http://hdl.handle.net/10564/142http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/142/1/KJ00004166155.pdf13450069AA11252383Journal of Nara Medical Association5641751812005-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1432017-05-29T06:06:33Zhdl_10564_1572当科における摂食・嚥下リハビリテーションORAL CARE AND TREATMENT IN PATIENTS WITH DYSPHAGIA IN OUR DEPARTMENT井上, 公秀川上, 正良青木, 久美子舘林, 茂山本, 一彦柳生, 貴裕桐田, 忠昭dysphagiarehabilitationoral hygieneswallowdental treatmentDysphagia is one of the disorders of nutrient intake associated with oral function. We have diagnosed and treated patients with dysphagia caused by various diseases. The number of patients referred by other departments in our hospital from January 2002 to January 2005 was 20, including 16 men and 4 women, with an average age of 66.9 years. Of these, 15 patients were evaluated by swallowing a jelly under endoscopic observation. The treatment included direct and/or indirect rehabilitation to improve the swallowing function or to prevent accidental swallowing, according to the dysphagia grade. Thirteen patients became able to take food orally after treatment. We concluded it is necessary to establish a system of team approach involving a speech therapist to evaluate and treat patients with dysphagia.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.4 p.183-18813450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/143Journal of Nara Medical Association, 56(4): 183-188http://hdl.handle.net/10564/143http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/143/1/KJ00004166156.pdf13450069AA11252383Journal of Nara Medical Association5641831882005-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1442017-05-29T06:07:05Zhdl_10564_1572SUPERFICIAL BRACHIAL ARTERY CONTINUING INTO THE FOREARM AS THE RADIAL ARTERYTohno, YoshiyukiTohno, SetsukoAzuma, ChoKido, KohjiMoriwake, Yumisuperfical brachial arterybrachial arteryupper limbhumanThe superficial brachial artery continuing into the forearm as the radial artery was observed in the right upper limb of an 86-year-old Japanese woman who died of pneumonia. The large-sized superficial brachial artery originating from the axillary artery descended ventral to the median nerve, crossed over the median nerve, and continued into the forearm as the radial artery. The small-sized brachial artery, the continuation of the axillary artery, gave off the deep brachial artery and continued into the forearm as the ulnar artery. The brachial artery joined the superficial brachial artery with an anastomotic branch.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.4 p.189-19313450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/144Journal of Nara Medical Association, 56(4): 189-193http://hdl.handle.net/10564/144http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/144/1/KJ00004166157.pdf13450069AA11252383Journal of Nara Medical Association5641891932005-08-31engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1452017-05-29T06:07:05Zhdl_10564_1572A CASE OF DOUBLE SUPERIOR VENAE CAVAE WITH PAIRED AZYGOS VEINSTohno, SetsukoAzuma, ChoTohno, YoshiyukiHasegawa, ShojiHamatani, ShioriHayashima, SadayukiHara, Ryotadouble superior venae cavaeazygos veinvenous anomalygross anatomyA case of double superior venae cavae with completely paired azygos veins was found in a 76-year-old Japanese man during an ordinary dissection by medical students at Nara Medical University in 2000. The left superior vena cava was formed by the union of the left internal jugular vein and the left subclavian vein, coursed vertically downward along the thoracic aorta, and entered the coronary sulcus. The vein ran horizontally toward the right in the coronary sulcus and opened into the right atrium. A typical left brachiocephalic vein was not found. The left superior vena cava was the same size as the right one, without communication between them. Paired azygos veins were present.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.4 p.195-20013450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/145Journal of Nara Medical Association, 56(4): 195-200http://hdl.handle.net/10564/145http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/145/1/KJ00004166158.pdf13450069AA11252383Journal of Nara Medical Association5641952002005-08-31engpublisher
oai:ginmu.naramed-u.ac.jp:10564/1462017-05-29T06:06:33Zhdl_10564_1572第125回奈良医学会 : 学会記事奈良医学会第125回学会記事奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.4 p.201-20413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/146Journal of Nara Medical Association, 56(4): 201-204http://hdl.handle.net/10564/146http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/146/1/KJ00004166159.pdf13450069AA11252383Journal of Nara Medical Association5642012042005-08-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1472017-06-11T23:20:26Zhdl_10564_1573表紙、目次、総目次、投稿規程詳細、奥付(Vol.56 No.5-6)表紙目次総目次投稿規程詳細奥付奈良医学会奈良県立医科大学OtherOthersapplication/pdfJournal of Nara Medical Association Vol.56 No.5-613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/147Journal of Nara Medical Association, 56(5-6)http://hdl.handle.net/10564/147http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/147/1/Vol.56%285-6%29_%ef%bc%9b_%e8%a1%a8%e7%b4%99%e3%80%81%e7%9b%ae%e6%ac%a1%e3%80%81%e7%b7%8f%e7%9b%ae%e6%ac%a1%e3%80%81%e6%8a%95%e7%a8%bf%e8%a6%8f%e7%a8%8b%e8%a9%b3%e7%b4%b0%e3%80%81%e5%a5%a5%e4%bb%98.pdf13450069AA11252383Journal of Nara Medical Association565-62005-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1482017-05-29T06:06:33Zhdl_10564_1573コラーゲン線維の配向性が生体組織の運動機能を決める : マイクロ波による新しい測定法の適用FIBER ORIENTATION OF COLLAGENS DETERMINES THE MOTIONAL FUNCTIONS IN BIOLOGICAL TISSUES : APPLICATION OF A NEW METHOD USING MICROWAVES大﨑, 茂芳collagenbiological tissuesfiber orientationfunctionsmicrowavesnew method最近注目を浴びているコラーゲン線維は,細胞外マトリックスの主要な構成要素であり,その配向性は生体組織の機能に大きく影響することが考えられる。ところが,生体組織におけるコラーゲン線維の配向性はほとんど注目されておらず,また,その配向性を測定する適切な方法もなかった。著者は,コラーゲン線維の配向性を25秒以内という迅速さで測定できる世界的に新しいマイクロ波方式(Osaki's microwave method)を見出した。その原理は,プローブとしてのマイクロ波とコラーゲン分子鎖の局所運動(β緩和)部の双極子との相互作用から,コラーゲン線維の配向性を検知するというものである。コラーゲンの分子構造とマクロの生体機能を繋ぐツールとして,マイクロ波方式を皮膚,骨,肺などの生体組織に適用した。その結果,コラーゲン線維の配向分布は生体組織における伸び縮みなどの運動機能をきわめて合理的に反映していることがわかってきた。そして,コラーゲン線維の配向分布に基づいた皮膚移植法も提案することができた。今後,様々な生体組織におけるコラーゲン線維の配向性と機能の関係を生活システムの観点からアプローチしたい。奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.5-6 p.205-22413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/148Journal of Nara Medical Association, 56(5-6): 205-224http://hdl.handle.net/10564/148http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/148/1/KJ00004432068.pdf13450069AA11252383Journal of Nara Medical Association565-62052242005-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1492017-05-29T06:07:05Zhdl_10564_1573天理よろづ相談所病院におけるせん妄の現状CASES OF DELIRIUM IN TENRI HOSPITAL池下, 克実奥村, 和夫中谷, 紀子米本, 重夫牧, 隆平菅原, 圭悟森川, 将行岸本, 年史deliriummortalitycomorbidityWe investigated the demographic characteristics of patients with delirium in the Department of Neuropsychiatry, Tenri Hospital, during the period from August 2003 to July 2004. Twenty-three patients (mean age 69 y.o.) were diagnosed with delirium, which included inpatients in other department wards. Seventeen patients (74%) of them were inpatients and 22 patients (96%) were referred from other departments. Fourteen patients (61%) suffered from tumor as a general medical condition. In order to treat delirium, haloperidol (44%), risperidone (17.5%), tiapride (17.5%) and quetiapine (13%) were used in each patient. Finally, 14 patients (61%) were cured of delirium and 4 patients were died from their physical complications.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.5-6 p.225-22813450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/149Journal of Nara Medical Association, 56(5-6): 225-228http://hdl.handle.net/10564/149http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/149/1/KJ00004432069.pdf13450069AA11252383Journal of Nara Medical Association565-62252282005-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1502017-05-29T06:07:05Zhdl_10564_1573奈良県立医科大学付属病院入院患者の転倒・転落事故リスク要因に関する前向き調査A PROSPECTIVE STUDY ON RISK FACTORS FOR SLIP-AND-FALL ACCIDENTS OF INPATIENTS IN NARA MEDICAL UNIVERSITY HOSPITAL高橋, 美雪林, 秀子車谷, 典男岡本, 康幸medical accidentslip-and-fallsafety managementrelative riskscoring systemSlip-and-fall of inpatients is a frequent and risky accident. It is difficult for nursing to prevent these accidents because they often occur along with a patient's voluntary action. Intensive observation of the patients at risk based on estimation of their risk levels is considered to be efficient. For this purpose, it is important to determine significant risk factors. Thus we conducted a prospective study on risk factors of slip-and-fall and established a scoring system to recognize patients at risk. In 1,922 inpatients, possible risk factors were systematically examined when on admission to our hospital, and the occurrence of slip-and-fall was observed during the period of hospitalization. Then relative risk values of the study factors were calculated, and these probabilities were converted to scores. Finally, 47 patients (2.4%) experienced a slip-and-fall accident. Each of the significantly higher risk factors was closely related to "limited activity", "poor cognition", "action for excretion", or "device- or nurse-assisted movement". The most discriminative cut-off score obtained from our scoring system showed the sensitivity of 66%, the specificity of 82%, the positive predictive value of 8%, and the negative predictive value of 99%. This cut-off score may be useful for screening the patients who are not in need of intensive observation. However, considering several limitations of this study, this system should be verified and improved in future.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.5-6 p.229-23413450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/150Journal of Nara Medical Association, 56(5-6): 229-234http://hdl.handle.net/10564/150http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/150/1/KJ00004432070.pdf13450069AA11252383Journal of Nara Medical Association565-62292342005-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1512017-05-29T06:06:33Zhdl_10564_1573入浴中の急死について : 奈良県における状況と文献的考察OCCURRENCE OF SUDDEN DEATH IN THE BATHROOM INVESTIGATED IN NARA PREFECTURE AND CONSIDERATIONS OF THE CAUSE OF DEATH IN LITERATURE羽竹, 勝彦工藤, 利彩森村, 佳史粕田, 承吾石谷, 昭子sudden deathbathroomadvanced ageinspectioncause of deathWe investigated 685 cases of sudden death while bathing in Nara Prefecture in a period of 5 years from 2000 to 2004, and the following parameters were evaluated: month of death, age distribution, sex, discovery locations, discovery facilities, discovery history, and past history of the deceased. The number of men under 70 years of age was approximately twice that of women in the same age group. However, the number of women over 70 years of age was slightly greater than that of men in the same age group. The cases of sudden death were most frequent in winter, from December to February. While 94.5% of the deceased died at home, 93.7% were found dead in the bathtub. With respect to the manner in which the deceased were discovered, 50.3% of the cases were discovered because their time in the bath was noticed to be longer than usual. A past history of hypertension was observed in most of the deceased, and the incidences of cardiovascular diseases, diabetes mellitus, and cerebrovascular diseases were lower as compared to hypertension. In this study, we also review the considerations of the cause of death in the literature.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.5-6 p.235-24613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/151Journal of Nara Medical Association, 56(5-6): 235-246http://hdl.handle.net/10564/151http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/151/1/KJ00004432071.pdf13450069AA11252383Journal of Nara Medical Association565-62352462005-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1522017-05-29T06:07:05Zhdl_10564_1573Myeloperoxidase部分欠損症の1新生児例AN INFANT WITH PARTIAL MYELOPEROXIDASE DEFICIENCY辰巳, 公平西久保, 敏也釜本, 智之坂東, 由香内田, 優美子西野, 正人梅木, 弥生亀岡, 洋祐伊東, 玲子鈴木, 和男myeloperoxidase deficiencyTechnicon H seriesinfantgenomic analysisWe encountered an infant with partial myeloperoxidase deficiency detected with an automatic peripheral blood analyzer, Technicon H series. A male neonate was admitted to our Neonatal Intensive Care Unit due to respiratory disturbance and low birth weight. An automatic peripheral blood analyzer, Technicon H, showed partial myeloperoxidase deficiency, and blood findings were abnormal. However, there were no apparent infectious diseases during hospitalization. Genomic analyses of the MPO coding region of the patient and his family showed normal expression of MPO mRNA, and there was no mutation of MPO cDNA detected by the direct sequence analysis. It was determined that MPO mRNA of the patient and family members were transcribed normally. These findings suggest that manifestation of partial MPO deficiency in this patient was caused by some mechanisms other than the mutation of the MPO coding region.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.5-6 p.247-25213450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/152Journal of Nara Medical Association, 56(5-6): 247-252http://hdl.handle.net/10564/152http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/152/1/KJ00004432072.pdf13450069AA11252383Journal of Nara Medical Association565-62472522005-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1532017-05-29T06:06:33Zhdl_10564_1573抗旋毛虫抗体陽性を示し、クマ肉生食により感染したと思われるウェステルマン肺吸虫症IMMUNOPOSITIVITY FOR TRICHINELLA SPIRALIS PRESENTED IN A CASE OF PARAGONIMIASIS WESTERMANI : SUSPECTED INFECTION BY INGESTION OF RAW BEAR MEAT吉川, 正英王寺, 幸輝守屋, 圭斉藤, 恒石坂, 重昭櫻井, 正樹森井, 武志福岡, 篤彦浜田, 薫木村, 弘高群, 美和殿村, 恭代矢倉, 一形岡, 博史上野, 聡中村(内山), ふくみ広松, 賢治名和, 行文Paragonimiasiszoonosisbear meatparatenic hostTrichinella spiralisWe treated a patient with paragonimiasis who showed a distinct immunopositivity for Trichinella spiralis. A 28-year-old male entered a local hospital in October 2003 because of acute renal failure, anemia, and multiple bone fractures. Intensive treatment was successfully performed, during which bilateral pleural effusion appeared transiently, with continuing eosinophilia and muscle weakness in the left upper arm. To examine the persistent eosinophilia and muscle weakness, the patient visited our hospital in April 2005. Neurological examinations and histological studies revealed muscle atrophy that was limited to the left upper arm, which was considered due to a local factor such as injection or injury. A hematological examination confirmed increased eosinophils (WBC 13300/μ1; eosinophils 44%). Further, chest X-P and CT images revealed a recurrence of bilateral pleural effusion and a nodular lesion in the upper lobe of the left lung. Since a strong immunopositivity against Paragonimus westermanii was demonstrated, we made a diagnosis of paragonimiasis. The patient was effectively treated with praziquantel and the clinical course was uneventful. In several interviews, the patient reported that he had not eaten crab; however, we discovered that he had eaten bear meat more than 5 times at a restaurant operated by his friend and ingested slices of raw bear meat on at least one occasion. A serological examination revealed a strong seropositivity for Trichinella spiralis. We considered that the Paragonimus westermanii infection in the present case was mediated by the ingestion of raw bear meat.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.5-6 p.253-25913450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/153Journal of Nara Medical Association, 56(5-6): 253-259http://hdl.handle.net/10564/153http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/153/1/KJ00004432073.pdf13450069AA11252383Journal of Nara Medical Association565-62532592005-12-31jpnpublisher
oai:ginmu.naramed-u.ac.jp:10564/1542017-05-29T06:09:10Zhdl_10564_1573腎細胞癌により2次性膜性腎症を発症したと思われるネフローゼ症候群の1例MEMBRANOUS NEPHROPATHY ASSOCIATED WITH RENAL CELL CARCINOMA PRESENTING AS NEPHROTIC SYNDROME吉本, 宗平中谷, 公彦浅井, 修赤井, 靖宏西野, 俊彦岩野, 正之斎藤, 能彦椎木, 英夫多武保, 光宏藤本, 清秀平尾, 佳彦membranous nephropathyrenal cell carcinomanephrotic syndromemalignant tumorA 69-year-old man was admitted to our hospital for evaluation of increasing edema. The laboratory findings showed that he had nephrotic syndrome. CT scan and MRI demonstrated a solid mass with a diameter of 4.0cm in the upper pole of the left kidney. Total left nephrectomy was performed on twenty-eighth day after admission. The histopathology of the removed kidney showed membranous nephropathy (MN) accompanied with clear cell renal cell carcinoma (RCC). Nephrectomy did not ameliorate nephrotic syndrome effectively and oral steroid administration was required for the treatment. Although MN is known to be commonly associated with malignancy, there are only 7 case reports describing association of MN with RCC. There is only one case report which showed complete remission of nephrotic syndrome after nephrectomy. We experienced a rare case with MN and RCC. It is essential to investigate the relationship between histological findings and the clinical course for the better understanding of the pathogenesis of tumor-associated MN.奈良医学会奈良県立医科大学ArticleDepartmental Bulletin Paperapplication/pdfJournal of Nara Medical Association Vol.56 No.5-6 p.261-26613450069http://ginmu.naramed-u.ac.jp/dspace/handle/10564/154Journal of Nara Medical Association, 56(5-6): 261-266http://hdl.handle.net/10564/154http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/154/1/KJ00004432074.pdf13450069AA11252383Journal of Nara Medical Association565-62612662005-12-31jpnpublisher
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