岡山医学会Acta Medica Okayama0030-155811432003第149回 岡山外科会335342ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003香川労災病院333334ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003井原市民病院329332ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003ピロリ菌 (Helicobacter pylori)325327ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003ヒト癌における遺伝子異常の検索と遺伝子診断309323ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003岡山県下で起きた早春室内での凍死例303308ENTakakiIshikawaSatoruMiyaishiYusukeDoiTomoyoTakataKiyomiImabayashiSachiyoInagakiKeiYoshitomeYujiYamamotoHideoIshizuWe encountered two cases of unnatural death occurring indoors in early spring in Okayama Prefecture. The two cases were both females aged 31yearsold and 88yearsold. Autopsies revealed death from hypothermia as the cause of death. The diagnosis of death from cold was not based solely on the characteristic findings of the dead body. After confirming that there were no other accidents and diseases that may cause death, an overall evaluation should be made considering the conditions surrounding occurrence of death from cold. We describe these procedures using these two autopsy cases of death from hypothermia.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003原発性肝癌の治療効果判定における経静脈性造影剤（Levovist）併用超音波検査の有用性の検討297302ENHiroharuShinmenWe have analyzed the usefulness of contrast-enhanced ultrasonography with Levovist for the evaluation of therapeutic effects on hepatocellular carcinoma (HCC).Therapeutic effects following treatments of HCC, including transcatheter arterial embolization and percutaneous microwave coagulation therapy, were confirmed with only dynamic CT in group A (8 cases, 10 tumors), or with both dynamic CT and contrast-enhanced ultrasonography with Levovist in group B (7 cases, 8 tumors). Local recurrence of HCC was checked 6 months after therapy. While recurrence was observed in 6 out of 10 tumors (60%) in group A, only one out of 8 tumors (12.5%) exhibited local recurrence in group B. The rate without recurrence of HCC in the follow-up 6 months (Kaplan-Meier method) was significantly higher in group B than in group A (P=0.045, Log-rank test). These findings suggest that contrast-enhanced ultrasonography with Levovist is useful for the evaluation of therapeutic effects on HCC.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003D-バリン培地法により選択的に初代培養したラット胆管上皮細胞に対する Phospholipase A(2) の細胞増殖促進効果の解析289296ENKaoruOguraYasuhiroWatanabeChiharuHiramineToshitakaNakagawaAkiraTokiMasaakiTokudaWe hypothesized that a high level of phospholipase A(2) (PLA(2)) in bile juice works as a growth factor of biliary epithelial cells and causes hyperplastic change of the bile duct in pancreaticobiliary maljunction. in order to examine this hypothesis, we established a primary culture system of biliary epithelial cells from the extra-hepatic bile duct of rats. We successfully excluded fibroblasts from the epithelial cells using D-valine-containing medium and the single-cell cloning method. The established cells exhibited the characteristic features of rat bile duct epithelial cells. They were stained with anti-cytokeratin antibody, a marker protein of epithelial cells, were positive with PAS stain, and possessed the architectures of microvilli, tonofilament fibers and desmosomes. The effect of PLA(2) on proliferation of these cells was then examined. We clearly demonstrated that PLA(2) at nano-molar concentration (50nM, 100nM), that is, equivalent to the level of PLA(2) in the bile juice of pancreaticobiliary maljunction cases, caused a significant enhancement of epithelial cell proliferation.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003原発性胆汁性肝硬変肝組織における Fas 発現の免疫組織化学的検討283288ENFumitoshiKishiThe expression of Fas on the epithelial cells of bile ducts was examined in liver specimens from 10 patients with primary biliary cirrhosis (PBC), and 14 patients with chronic hepatitis by both light and electron microscopy using the indirect peroxidase-labeled antibody method. In all patients with PBC, Fas was observed on the surface of epithelial cells of interlobular bile ducts. By electron microscopy, electron-dense reaction products of Fas were detected on the basolateral plasma membrane of the bile duct epithelial cells, as well as on some membranes of the endoplasmic reticulum. Fas was expressed more strongly on the surface of the epitherial cells of interlobular bile ducts in PBC than of those in chronic hepatitis. These findings suggest that increased expression of Fas on such bila ducts may play some role in the pathogenesis of PBC.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003インターフェロン治療後C型慢性肝炎患者の長期予後 ―ウイルス学的著効例，生化学的著効例と無効例の比較―275281ENMasanobuMiyakeTo evaluate the prognosis of the sustained biochemical responder after interferon (IFN) therapy, we retrospectively studied 252 chronic hepatitis C patients who were treated with IFN. Patients were divided into four groups: group A, sustained virological responders (n=84); group B,sustained biochemical but not virological responders (n=43); group C, incomplete responders (n=64); group D, non responders (n=61). The levels of several liver function tests were evaluated at the end of the observation period (4.2±1.6 years, mean±SD) compared with those at just before IFN therapy. The levels of cholinesterase, albumin, γ-globulin, zinc sufate turbidity test, platelet count and clearance rate of indocyanine green test improved in group A (p<0.05), became worse in group D (p<0.05) and did not change in group B. The incidence of hepatocellular carcinoma was significantly higher in group D than in group B (p<0.01);Kaplan-Meier method, log-rank test). The hazard ratio for hapatocarcinogenesis of the patients in group A and B was significantly lower than that in group C and D (hazard ratio: 0.27, range of 0.08-0.98; p=0.046) adjusted for age, gender, stage and total alcohol consumption.
These results suggest that the progress of liver disease and liver carcinogenesis was more suppressed in sustained biochemical responders than in non reponders.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003スーパーマイクロサージャリーを用いた形成再建外科267274ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003死体肺移植における一酸化窒素吸入（NO）の有効性と至適投与時間についての実験的検討261266EN肺移植の普及と共に,ドナー不足は深刻な問題となっています.もし心停止ドナーからの肺の使用が可能ならば,ドナーの増加に大きく寄与するものと思われます.しかしながら死体肺移植に関しては,温阻血時間に伴う術後早期の移植肺機能不全が,大きな問題になると予想されます.今回私達は,死体肺移植において,温阻血時間の延長及び呼吸機能の改善に対する一酸化窒素(NO)吸入の有効性と,更にその至適投与時間についての実験的検討を行いました.雑種成犬を用い,ドナーをヘパリン化することなく,心停止後3時間室温にて放置の後,左片肺移植を行いました.移植後対側肺動脈及び気管支を結紮し,移植肺機能を6時間評価しました.100%酸素換気下に,再潅流直前より評価終了時までNO40ppmを持続吸入した群(group 1, n=6),評価開始後1時間までNO40ppmを持続吸入,以後終了時まで,Saturationを一致させるために,窒素40ppmを同じく持続吸入した群(group 2, n=6)及び,再潅流直前より評価終了時まで,窒素を持続吸入した群(group 3,n=6)とを比較検討しました.生存時間,動脈血酸素分圧(PaO(2)),動脈血二酸化炭素分圧(PaCO(2)),湿乾燥重量比(W/D ratio),気道内の吸引量の結果より,NO吸入により虚血再潅流障害軽減による呼吸機能の改善並びに,肺水腫の抑制が示唆されました.またmyeloperoxidase activity (MPO)の有意な低下と,肺血管抵抗(PVR)の低下が認められました. group 1とgroup 2の間には,これらの結果について特に有意な差は認めませんでした.従って,NO吸入が,死体肺移植において,温阻血時間の延長及び呼吸機能の改善に対し有効であり,しかも再潅流直前より短期間の吸入で持続吸入と同様の効果が得られるものと思われます.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003癌抑制遺伝子 ING ファミリーの構造と機能253259ENMehmetGunduzNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811432003肝臓を標的とした細胞療法243251ENNaoyaKobayashiNo potential conflict of interest relevant to this article was reported.