JaLCDOI 10.18926/21087
Title Alternative Endoscopic diagosis of gastric malignant lymphoma
FullText URL pitsr_056_045_052.pdf
Author Miyake, Hirofumi| Harada, Hideo| Yasuoka, Masatoshi| Oka, Hiroo| Matsumoto, Shuji| Ochi, Koji| Takeda, Masahiko| Tanaka, Juntaro| Ohnoshi, Taisuke| Kimura, Ikuro|
Abstract To delineate the pitfalls and counter-measures in the endoscopic diagnosis of gastric malignant lymphoma (GML), reviewed were 32 cases of primary GML and 16 cases of systemic ML with gastric involvement (secondary GML). 1) Accurate diagnosis of GML had been made in only 13 cases of primary GML ; 18 cases had been diagnosed of gastric cancer (GC); the remaining one of benign ulcer (BU). Review of the endoscopic films, however, revealed more than two of the three findings characteristic, but not pathognomomic, of GML in 84 percent. This result indicates that possibility of GML must be kept in mind in the differential diagnosis of malignant lesions despite its rarity, because endoscopists tend to be predisposed with an impression of GC. 2) Follow-up examinations made in nine cases of primary GML revealed marked changes in endoscopic findings in three cases : healing of an ulcer lesion in one case, healing of an ulcer lesion on an unchanged tumor in another and enlargement of a tumor in the remaining one. The first case had been followed up for two years with an impression of BU. This result indicates that improvement of ulcer does not necessarily rule out GML because it can show "malignant cycle" just as GC. 3) Endoscopic biopsy performed in 30 cases of primary GML had led to accurate diagnosis in only 16 cases and erroneous diagnosis of GC in five and no malignancy in nine. Review of the cases revealed the importance of having suspicion of GML at first from endoscopic findings, because it can lead to an increase of the number of biopsy specimens, careful selection of biopsy sites, careful use of biopsy instruments to obtain good specimens and closer contact with pathologists. 4) Prospective studies on systemic ML revealed gastric involvement in 17 percent. Examinations of the GI tract, especially of the stomach is one of the important steps for staging of systemic ML and deciding therapeutic modalities. 5) It is extremely difficult to diffierentate primary GML and secondary GML from endoscopic findings alone, although there are a few findings characteristic of the latter.
Publication Title 岡山大学温泉研究所報告
Published Date 1985-03-30
Volume volume56
Start Page 45
End Page 52
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310992
JaLCDOI 10.18926/19825
Title Alternative Classification and concepts of pancreatitis
FullText URL 060_083_093.pdf
Author Harada, Hideo| Tanaka, Juntaro| Ochi, Koji| Matsumoto, Shuji| Ishibashi, Tadaaki| Seno, Toshinobu| Miyake, Hirofumi|
Abstract 膵炎の分類は膵臓研究の進歩とともに変遷を重ねたが,ここ20年間はマルセイユ分類(1963年)が国際的に広く用いられてきた。しかし最近,膵検査法の進歩と膵研究の知見の蓄積を背景にして,ケンブリッジ(1983年),マルセイユ(1984年),およびローマ(1988年)において分類の改訂を目的に国際シンポジウムが開催され,それぞれに新しい膵炎の分類が提案された。各分類には多くの共通点が見られるが重要な相違点もある。各分類を十分に理解していないとしばらくは混乱に陥ることが危惧される。幸い筆者の1人はこれらのシンポジウムに招待され参加する機会を得たので,成文の背景にある討議を詳しく紹介し,各分類を比較しながらその特徴を述べた。それとともに将来理想的な分類を完成するために今後検討すべき課題をも指摘した。そして,これら分類の当面の利用法に関する筆者らの提案を述べた。
Abstract Alternative The present paper is a review of the historical changes in the classification and concept of pancreatitis. The Marseille classification and concept had enjoyed its international popularity for more than 20 years since it was adopted at the first Marseille symposium in 1962. However, the recent advancement in the study of the pancreas led to the attempts to revise the classification and concept of pancreatitis : International Symposium in Cambridge in 1983, Second International Symposium in Marseille in 1984 and Symposium at the International Congress of Gastroenterology in Rome in 1988. As one of us was invited to the last two symposia, we described the details of the revised classification and concept of Marseille (1984) and of Marseille-Rome (1988) ; then, we described the similarities and differences between the Cambridge classification, the revised Marseille classification and the Marseille-Rome classification. Finally we summarized the subjects to be further investigated to make better classification of pancreatitis in the future.
Keywords 膵炎 分類 (Classification and concepts of pancreatitis) 急性膵炎 (Acute pancreatitis) 慢性膵炎 (Chronic pancreatitis)
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 83
End Page 93
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309066
JaLCDOI 10.18926/19821
Title Alternative Interstitial matrix components in relation to the pathogenesis of fibrosis
FullText URL 060_076_082.pdf
Author Seno, Toshinobu| Harada, Hideo| Ochi, Koji| Tanaka, Juntaro| Matsumoto, Shuji| Ishibashi, Tadaaki| Takeda, Masahiko| Miyake, Hirofumi|
Abstract 慢性膵炎の症例は近年増加の一途をたどっており,その発症機序と病態の解明および対策の確立が急がれている。慢性膵炎の重要な所見の一つである膵間質線維化の発生機序の解明および早期発見法の確立は重要な課題であるが,従来の知見は断片的にすぎない。そこで,筆者らは膵線維化の系統的な研究を始めるにあたって,細胞間マトリックスの構成成分と線維化に関する従来の知見および今後の課題を整理した。細胞間マトリックスのうちでも特にコラーゲン,グリコサミノグリカン,フィブロネクチンをとりあげ,その構造と機能および組織の線維化形成における役割について文献的考察を行った。今後,膵組織および膵液中のプロリンハイドロキシラーゼ,コラーゲンとその型別分布および各型コラーゲンの比,ヘキソサミン,デルマタン硫酸,フィブロネクチン,ラミニンを検討することが重要と思われた。
Abstract Alternative Increasing numbers of patients with chronic pancreatitis have been reported all over the world, including Japan. Pathogenesis of chronic pancreatitis has remained to be revealed and the early detection has remaind difficult despite extensive investigations. Interstitial fibrosis forms one of the most important histopathological features of chronic pancreatitis along with loss of parenchyma and irregular dilatation of the ducts and ductules. However, only a limited numbers of reports have been pubiished on the pathogenetic mechanisms of interstitial fibrosis of the pancres, because tissue materials are not easily accessible and blood samples can hardly reflect the fibrotic process of the pancreas unlike the case of the iiver. Our Preliminary studies revealed that biochemical and immunochemical analysis of pure pancreatic juice, such as determination of collagen, hexosamine, fibronectin and proline hydroxylase, might reflect the fibrotic process of the pancreas. The results led us to review the earlier reports on inter-cellular matrix in relation to the formation of fibrosis to find suitable markers to be evaluated in the future systematic investigations. The review revealed that pure pancreatic juice should be analyzed for collagen, types of collagen, hexosamine, dermatan sulfate, fibronectin, larninin, proline hydroxylase, collagenase and cathepsin B(1).
Keywords 慢性膵炎 (Chronic pancreatitis) 膵の線維化 (Interstitial fibrosis of the pancreas) 膵間質成分 (Interstitial matrix of the pancreas)
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 76
End Page 82
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309179
JaLCDOI 10.18926/19669
Title Alternative Diagnosis of chronic pancreatitis
FullText URL 057_029_036.pdf
Author Takeda, Masahiko| Harada, Hideo| Matsumoto, Shuji| Ochi, Koji| Tanaka, Juntaro| Yoshida, Mitsuo| Oka, Hiroo| Miyake, Hirofumi| Kimura, Ikuro|
Abstract 近年,各種膵疾患に対する検査法の発達には目を見張るものがあるが,実際の運用にあたっては各検査法の適応,限界,組合わせおよび実施する順序等に迷うことが少なくない。本研究では,最近我々が経験した慢性膵炎Ⅰ群116例の診断過程を振り返ることにより,慢性膵炎の診断における理想的な検査法の組合わせとそれぞれの役割を検討し,同時に診断名のみならず病態と病期が容易に理解できる表現方法を提案した。画像診断法,膵外分泌機能検査法(EX),膵内分泌機能検査法(EN)を比較検討し,以下の結果を得た。①画像診断法は必須である。②内視鏡的逆行性膵胆管造影(ERCP)を軸とした腹部超音波検査(US)あるいは腹部CTスキャン(CT)の組合わせは欠くことができない。③EXもまた必須の検査法である。④ENは慢性膵炎の診断に必要不可欠ではないが,治療方針を決めるうえで重要である。⑤純粋膵液(PPJ)の生化学的検査と組織化学的検査は膵炎の診断と病態生理の解明に重要である。⑥PPJ中の細胞診は慢性膵炎に合併した膵癌の検索に有用である。⑦以下に示すような診断の記載方法を提案した。"Calcified chronic pancreatitis, alcoholic, diffuse, ERCP-3, US-2, CT-3, EX-2, EN-1, Lf(+)"。
Abstract Alternative Endoscopic retrograde cholangiopancreatography (ERCP), ultrasonography (US), computed tomography (CT), exocrine pancreatic function test (EX), endocrine pancreatic function test (EN), and analysis of pure pancreatic juice (PPJ) are currently available for the investigation of pancreatic diseases. The purpose of the present study is to evaluate the roles and preferable combinations of these tests in the diagnosis of chronic pancreatitis and then to propose a way to describe the results of the tests along with diagnosis for a better understanding of the disease process. Comparative studies of imaging, EX and EN led to the following conclusions. 1) imaging procedures (ERCP, US and CT) are mandatory, partly because they were frequently the test that showed diagnostic changes and partly because they often gave key information for operative treatment. Among the imaging procedures, ERCP combined with US and/or CT is mandatory because these combinations alone can reveal detailes of structural changes attendant on chronic pancreatitis. 2) EX is also mandatory, because it was occasionally the only test that showed diagnostic changes and partly because it often gave important information for medical treatment. 3) EN is also important, not because it was indispensable for detecting chronic pancreatitis, but because it often gave important information for medical treatment. For btter understanding of the disease process as well as diagnosis, we propose, as suggested by Seligson, that the test used for the establishment of the diagnosis and the degree as well as extent of abnormalities. An example is "Calcified chronic pancreatitis, alcoholic, diffuse, ERCP-3, US-2, CT-3, EX-2, EN-1, Lf(+)". This attitude will lead to a more rational approach to both diagnosis and treatment.
Keywords 慢性膵炎 (chronic pancreatitis) 画像診断 (imaging diagnosis) PS試験 (pure pancreatic juice) 純粋膵液(PPJ) (Pancreozymin-Secretin test) 内視鏡的逆行性膵胆管造影(ERCP) (endoscopic retrograde cholangiopancreatography (ERCP))
Publication Title 環境病態研報告
Published Date 1986-07
Volume volume57
Start Page 29
End Page 36
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309023
JaLCDOI 10.18926/15326
Title Alternative Clinical evaluation of an endoscopic image filing system, Olympus SDF-3
FullText URL 063_074_078.pdf
Author Ochi, Koji| Miyake, Hirofumi| Matsumoto, Shuji| Seno, Toshinobu| Tanaka, Juntaro| Harada, Hideo| Mitsunobu, Fumihiro| Tanizaki, Yosiro|
Abstract 光ディスクとパーソナルコンピュータを組み合わせた内視鏡画像ファイリングシステムは電子内視鏡の画像の保存・管理,検索・再生などに威力を発揮する。今回,われわれはオリンパス社製内視鏡ファイリングシステムSDF-3を使用する機会を得たので,その有用性や問題点の検討を行った。有用性としては,①内視鏡画像を検査終了後直ちに再生し,再検討できる,②多数の項目についての検索や統計処理が可能である,③限られたスペース内で大量の画像データの一括保存・管理が可能であるなどが挙げられる。一方,問題点としては,①内視鏡再生画像は画質が劣化する,②検索機能を十分に活用するにはかなり煩雑な人力操作を必要とする,③光ディスクの清掃が必要であるなどがあげられる。本内視鏡ファイリングシステムに今後必要な改良点やその展望についても合わせて考案を加えた。
Abstract Alternative Olympus SDF-3, an endoscopic image filing system using an electronic endoscope in conjunction with a personal computer and an optical disk, has been recently developed. We evaluated the usefulness of this filing system with 449 cases of gastroduodenal endoscopy. As a result, we have found that this filing system has following advantages : (1) one can review endoscopic images immediately after endoscopic examinations ; (2) previously documented endoscopic image can be searched and reviewed in a short time ; (3) statistical analysis of documented cases is facilitated. However, it has some disadvantages as well to be improved : (1) quality of endoscopic images is deteriorated in the process of filing ; (2) putting patients' data into the filing system is time-consuming ; (3) frequent cleaning of an optic disk is required. This endoscopic image filing system needs to be further developed and refined.
Keywords 画像ファイリングシステム (image filing system) 電子内視鏡 (electronic endoscope)
Publication Title 岡大三朝分院研究報告
Published Date 1992-06
Volume volume63
Start Page 74
End Page 78
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002307278
Author Miyake, Hirofumi|
Published Date 1991
Publication Title 岡山医学会雑誌
Volume volume103
Issue issue5-6
Content Type Journal Article
Author Miyake, Hirofumi|
Published Date 1991
Publication Title 岡山医学会雑誌
Volume volume103
Issue issue5-6
Content Type Journal Article
Author Miyake, Hirofumi|
Published Date 1991
Publication Title 岡山医学会雑誌
Volume volume103
Issue issue5-6
Content Type Journal Article
JaLCDOI 10.18926/11674
Title Alternative Development of stepping measurement device for evaluation of and training in walking
FullText URL 061_123_128.pdf
Author Matsumoto, Shuji| Ochi, Koji| Tanaka, Juntaro| Tachibana, Hideo| Seno, Toshinobu| Harada, Hideo| Tsuboi, Keiichi| Miyake, Hirofumi| Kimura, Ikuro|
Abstract 急性膵炎の回復後その発症原因の検索において発見された小膵癌の3例を報告し,膵炎の発症原因の一つとして膵癌を常に念頭におく必要があることを強調した。またスクリーニング検査および精査において小膵癌を診断する手順について考察を加えた。症例1は初回発作の回復後に,症例2および症例3は再発発作の回復後に急性膵炎の発症原因の検索を目的に紹介された。いずれの症例においても血清腫瘍マーカーは正常植を示し,腹部USおよびCTは腫瘍から尾側の膵管の拡張を示したが腫瘍そのものは描出はできなかった。症例1ではERCP像から膵体部癌を強く疑い,症例2と症例3ではERCP像と細胞診陽性所見から膵頭部癌と確診し,手術を行った。腫瘍の最大径は症例1では0.9cm,症例2では1.5cm,症例3では2.0cmであり,いずれも転移を認めず根治切除可能であった。
Abstract Alternative Although gait training equipment such as the bicycle ergometer and treadmill exists for patients whose walking ability is high, there is no appropriate gait training mehtod or training instrument for patients whose walking ability has become impaired, who often use a cane or walker, etc. in the course of daily life. In the case of gait training for persons whose walking ability involves impaired locomotion, there is always the danger of a fall. Consequently, a caregiver is required, and the effect of the training is cut by half because the patient's anxiety about falling is exacerbated. Slow stepping affords strengthening and balance training of the leg muscles for patients whose walking ability has become low, and walking ability is improved. However,whether such training appropriately carries out stepping and the degree of the effect of such training has not been evaluated. Therefore, we have developed a stepping measturement device that monitors stepping for evaluation and training of walking ability. This system consists of two mat switches for stepping, a measuring circuit for stepping detection, and a book-sized personal computer with a PC card-type AD converter. This system can detect a left or right single stance phase and a double stance phase relative to the ON, OFF condition of the mat switch. After measurement, the following items are analyzed and displayed : ・number of steps, ・average time of double stance phase, ・the average time of single stance phase, and so on. Finally, we measured the stepping of subjects whose walking ability is low, and showed the relationship between daily walking conditions and stepping conditions. The effectiveness of this system was considered in light of the results.
Keywords 小膵癌 (Small pancreatic cancer) 膵癌の早期発見 (Early diagnosis of pancreatic cancer) 急性膵炎 (Acute pancreatitis)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 123
End Page 128
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313750