岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026説明的文章の指導における「内省」を促す批判的読み ―高等学校１年生を対象として―1529ENYumiSAISHOGraduate School of Education (Professional Degree Corse), Okayama UniversityMasafumiIKEDAFaculty of Education, Okayama University10.18926/CTED/70357 批判的読みは，現代では欠かせない能力であり，学習指導要領にも明記されている。近年，批判的読みの指導に関する研究がなされているものの，内容的な価値の検討や社会的な文脈のなかで捉えることが希薄だとする指摘や，「反省性」という観点に着目した批判的読みを求める声もある。そこで，本稿では，文章そのものを批判的に読むだけでなく，自身の持っている考えをも批判的に捉える（内省する）ことを促す授業を開発した。その手立てとして，複数の社会認識が存在する二つの教材の読み比べたうえで，対立する立場からの意見交換を行うことや，教材に対する評価の記述，その記述（自己の読み）を学習者自身が評価するといった活動を取り入れた。学習者の記述の分析からは，意識的な内省に至らなかった学習者も見受けられたものの，約６割の学習者の記述には変容が見られ，用いた手立ては効果があったと推測できることを指摘した。No potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414402026昭和初期における郷土国語読本の検討 ―芦田恵之助と繋がりの深い宇和島和霊尋常小学校における読本編纂―(23)(36)ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231912026腎機能の理解を促すための教材開発と中学校理科における授業実践111117ENMotonoriANDOFaculty of Education, Okayama UniversityRisaIKEDASeishin Junior High School/Seishin Girls’ High SchoolFukutoTANAKASeishin Junior High School/Seishin Girls’ High School10.18926/bgeou/70200 本研究では腎臓におけるろ過後，ろ液の成分がどのような物質で構成されているのか，その後の腎臓での再吸収過程を含めて，中学生の腎機能の理解を促す教材開発を試みた。まず，市販の果汁を含む飲料水をメンブレンフィルターでろ過し，ろ液が透明になるのは不溶性物質が除去されるためであること，また，ろ液の甘さから水溶性の糖分はろ過されることを確認した。開発した腎臓糸球体モデルは，腎小体に見立てた蓋に孔を開けたプラスチック容器，赤血球や血液中に存在する様々な物質を模した色や大きさの異なるビーズ，から構成される。生徒は，この教材を用いた授業実践を経て，血球以外の水溶性成分は要不要に関わらず一旦腎小体でろ過されてしまうこと，生体に必要なブドウ糖は尿細管において能動的に再吸収されることを理解し，腎臓のろ過と再吸収に関する新しい考え方と関連する概念を獲得することができた，と考えられた。本研究で開発した教材を用いることにより，生徒の腎臓の役割についての理解を深化させること，同時に自身の健康への関心を高めさせること，について有効であることが分かった。No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1328-80676712025Changes in body mass index during early childhood on school‐age asthma prevalence classified by phenotypes and sexe70090ENToshihikoYabuuchiDepartment of Pediatrics, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityMasanoriIkedaDepartment of Pediatrics, Okayama University Medical SchoolNaomiMatsumotoDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMitsuruTsugeDepartment of Pediatrics, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHirokazuTsukaharaDepartment of Pediatrics, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityBackground: Few studies have explored the relationship between changes in body mass index(BMI) during early childhood and asthma prevalence divided by phenotypes and sex, and the limited results are conflicting. This study assessed the impact of BMI changes during early childhood on school-age asthma, classified by phenotypes and sex, using a nationwide longitudinal survey in Japan.<br>
Methods: From children born in 2001 (n = 47,015), we divided participants into BMI quartiles (Q1, Q2, Q3, and Q4) and the following BMI categories: Q1Q1 (i.e., Q1 at birth and Q1 at age 7), Q1Q4, Q4Q1, Q4Q4, and others. Asthma history from ages 7 to 8 was analyzed, with bronchial asthma (BA) further categorized as allergic asthma (AA) or nonallergic asthma (NA) based on the presence of other allergic diseases. Using logistic regression, we estimated the asthma odds ratio (OR) and 95% confidence intervals (CIs) for each BMI category.<br>
Results: Q1Q4 showed significantly higher risks of BA, AA, and NA. In boys, BA and NA risks were significantly higher in Q1Q4 (adjusted OR: 1.47 [95% CI: 1.17–1.85], at 1.56 [95% CI: 1.16–2.1]), with no significant difference in AA risk. In girls, no increased asthma risk was observed in Q1Q4, but AA risk was significantly higher in Q4Q4 (adjusted OR: 1.78 [95% CI: 1.21–2.6]).<br>
Conclusion: Our results demonstrated that BMI changes during early childhood impact asthma risks, particularly that the risk of NA in boys increases with BMI changes during early childhood, and the risk of AA in girls increases with consistently high BMI.No potential conflict of interest relevant to this article was reported.Oxford University Press (OUP)Acta Medica Okayama0032-07816652024SHORT AND CROOKED AWN, encoding the epigenetic regulator EMF1, promotes barley awn development705721ENKokiNakamuraInstitute of Plant Science and Resources, Okayama UniversityYuichiKikuchiInstitute of Plant Science and Resources, Okayama UniversityMizuhoShiragaInstitute of Plant Science and Resources, Okayama UniversityToshihisaKotakeGraduate School of Science and Engineering, Saitama UniversityKiwamuHyodoInstitute of Plant Science and Resources, Okayama UniversityShinTaketaInstitute of Plant Science and Resources, Okayama UniversityYokoIkedaInstitute of Plant Science and Resources, Okayama UniversityThe awn is a bristle-like extension from the tip of the lemma in grasses. In barley, the predominant cultivars possess long awns that contribute to grain yield and quality through photosynthesis. In addition, various awn morphological mutants are available in barley, rendering it a useful cereal crop to investigate the mechanims of awn development. Here, we identified the gene causative of the short and crooked awn (sca) mutant, which exhibits a short and curved awn phenotype. Intercrossing experiments revealed that the sca mutant induced in the Japanese cultivar (cv.) “Akashinriki” is allelic to the independently isolated moderately short-awn mutant breviaristatum-a (ari-a). Map-based cloning and sequencing revealed that SCA encodes the Polycomb group–associated protein EMBRYONIC FLOWER 1. We found that SCA affects awn development through the promotion of cell proliferation, elongation, and cell wall synthesis. RNA sequencing of cv. Bowman backcross-derived near-isogenic lines of sca and ari-a6 alleles showed that SCA is directly or indirectly involved in promoting the expression of genes related to awn development. Additionally, SCA represses various transcription factors essential for floral organ development and plant architecture, such as MADS-box and Knotted1-like homeobox genes. Notably, the repression of the C-class MADS-box gene HvMADS58 by SCA in awns is associated with the accumulation of the repressive histone modification H3K27me3. These findings highlight the potential role of SCA-mediated gene regulation, including histone modification, as a novel pathway in barley awn development.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025学校統廃合における児童の適応支援策の提言357371ENYukaIKEDAGraduate School of Education (Professional Degree Corse), Okayama UniversityTsuguyukiIZUMIFaculty of Education, Okayama University10.18926/CTED/68504本研究の目的は，学校統廃合に係る文献検索および実態調査を通して，学校統廃合という環境移行が児童に与える影響について検討し，学校統廃合がもたらす環境移行に対する児童の適応支援策について提言することである。まず，学校統廃合に係る文献検索を行った結果，学校統廃合の経験が児童生徒のその後の人間関係形成やストレス反応の増加に影響を与えている可能性が示された。しかし，学校統廃合が児童に与える影響に関する研究は非常に少なく，統廃合の経験が児童に与える心理的影響については十分に解明されていないことがわかった。次に，実態調査として行ったインタビューにおいて，学校統廃合が児童にとって大きなストレス要因となる可能性があることがわかった。これらの現状を踏まえて，学校統廃合が児童に与える影響を和らげるため，特別活動を中心として，個人・学級・学年・学校レベルでの具体的な取組を提案した。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025中学校理科教科書がつくり上げてきたきのこ像 ―通時的調査から得るきのこを巡る学習への示唆―133145ENRisaTAKAGIGraduate School of Education (Professional Degree Corse), Okayama UniversityMasafumiIKEDAFaculty of Education, Okayama UniversityMasayaYAMAMOTOHyogo University of Teacher Education10.18926/CTED/68487 本稿では，戦後中学校理科検定教科書におけるきのこの扱われ方，すなわち学習者が受け取ることになるきのこ像について，@どのようなきのこが扱われてきたのか，A植物に分類されているか否か，Bきのこのからだは何で形成されているのか，C生態系における働きの四つの観点から，通時的な調査によって明らかにした。全47種がこれまでの理科教科書で登場してきたが，近年は種への意識というよりも，きのこが分解者としての役割を持つことにのみ焦点が当てられてきていることを指摘した。また，これまで教科書においては菌根性のきのこ自体について取り上げられつつも，その生態系における相利共生の観点への言及はないことから，相利共生の理解を目指す学習の開発が可能性として浮かび上がってくることも指摘した。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025学校図書館の活用と司書教諭・学校司書との協働をめぐる国語教育思潮の展開 ―『教育科学国語教育』誌の調査から―119132ENYumiSAISHOGraduate School of Education（Professional Degree Corse），Okayama UniversityMasafumiIKEDAFaculty of Education，Okayama University10.18926/CTED/68486 学校図書館は，学習指導要領でも触れられており，国語科との関連も深い。また先行研究では，司書教諭や学校司書との協働の必要性が訴えられている。しかしこれまでの国語教育では，どのような協働がなされていたのかという検討がなされていない。そこで，本研究では，教育雑誌の調査をもとに，国語科においては，学校図書館がどのように活用されてきたのか，司書教諭や学校司書との協働はどのような態度がとられてきたのかを明らかにすることを目的とした。調査では，図書館に言及している論文や学校図書館を活用した実践・指導例を抽出し，分析した。実践・指導例の分析からは，小・中学校の国語科において学校図書館は活用されてきた一方で，司書教諭や学校司書との協働には着目が及んでいない状況が明らかになった。また，司書教諭や学校司書に関する言及からは，人的リソースにその原因を求める思潮が窺えたものの，価値ある協働も見受けられることを指摘した。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025小学校における組織的な授業改善のあり方 〜「目指す子ども像」実現に向けた国語科指導を事例として〜3344ENAkihiroKOMOTOHayashima Elementary School (Graduate School of Education (Professional Degree Corse), Okayama University)KojiMIYAMOTOFaculty of Education, Okayama UniversityMasafumiIKEDAFaculty of Education, Okayama UniversitySatoshiMATUDAFaculty of Education, Okayama University10.18926/CTED/68480 本研究の目的は、「目指す子ども像」実現に向けた国語科の授業づくりの具体を検討し、小学校における組織的な授業改善のあり方を提言することにある。具体的には、「目指す子ども像」実現に向けた国語科の授業づくりを通して、今の社会が小学校教育に求める特色ある授業づくりの進め方を明らかにするため、勤務校である早島町立早島小学校に所属する教師の授業づくりを対象に事例研究を展開した。検討を通じて明らかになったことは、授業づくりにおける教師の思考・実践過程と、これらを実践者が反省的に捉え直すための「目指す子ども像」による言語活動具体化の手立てである。さらに、授業づくりの組織・系統性は、他学年教師の役割によってもたらされることが確認されたことから、それらを踏まえつつ、「目指す子ども像」実現に向けた授業づくりのあり方を体系化した。そうすることで、小学校における組織的な授業改善を進めていくための可能性が見出された。No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1710-14922112025Maternal smoking during infancy increases the risk of allergic diseases in children: a nationwide longitudinal survey in Japan4ENKenjiShigeharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNaomiMatsumotoDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMitsuruTsugeDepartment of Pediatric Acute Diseases, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKazuhiroUdaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYukieSaitoDepartment of Pediatrics, Okayama University HospitalMasatoYashiroDepartment of Pediatrics, Okayama University HospitalTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMasanoriIkedaDepartment of Pediatrics, Okayama University HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesBackground The incidence of allergic diseases has been increasing in Japan. In particular, a serious decline in the age of onset of allergic rhinitis has been observed. Passive smoking from parental smoking has a significant impact on children’s health; however, it is difficult to restrict smoking in the home. While various studies have previously reported on the relationship between passive smoking and the development of allergic diseases in children. However, there have been no reports on passive smoking and allergic diseases on a national scale.<br>
Methods Using Japanese national longitudinal survey data (n = 38,444) for newborns born between May 10 and 24, 2010, we assessed parental smoking habits when their children were 6 months old and investigated the association with the development of allergic diseases until the age of 5.5 years. The risk ratios and 95% confidence intervals for the development of different allergic diseases were analyzed after adjusting for potential confounders using Poisson regression with a robust error variance.<br>
Results The risk ratio for developing allergic rhinitis/allergic conjunctivitis (AR/AC) in children was significantly higher in the maternal smoking groups ( ≦ 10 cigarettes/day; RR 1.15, 95% CI 1.02–1.30; ≧11 cigarettes/day; RR 1.16, 95% CI 0.93–1.44). Furthermore, associations were found between the maternal smoking group in the presence of paternal smoking and the risk of developing bronchial asthma ( ≦ 10, RR 1.33 95% CI 1.17–1.52; ≧11, RR 1.71 95% CI 1.38–2.1), food allergy ( ≦ 10, RR 1.36 95% CI 1.12–1.63; ≧11, RR 1.25 95% CI 0.84–1.86), atopic dermatitis ( ≦ 10, RR 1.42 95% CI 1.22–1.66; ≧11, RR 1.6 95% CI 1.2–2.13), and AR/AC ( ≦ 10, RR 1.21 95% CI 1.07–1.36; ≧11, RR 1.35 95% CI 1.09–1.67).<br>
Conclusions Maternal smoking during infancy increases the risk of developing AR/AC in children. Considering paternal smoking, maternal smoking further increased the risk of developing allergic diseases in children, suggesting that reducing parental smoking at home may reduce the risk of developing allergic diseases in children.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024「目指す生徒像」を意識した組織的な授業改善 〜「自ら学び、思いや考えを伝え合う力」を育む国語科指導を軸として〜265279ENNamiOKADAIbara Junior High School (Graduate School of Education (Professional Degree Corse), Okayama University)KojiMIYAMOTOFaculty of Education, Okayama UniversityMasafumiIKEDAFaculty of Education, Okayama UniversityShigekoMAKINOFaculty of Education, Okayama University10.18926/CTED/66786 本研究の目的は、「目指す生徒像」を意識した学校の組織改善の具体を報告し、そのあり方を提言することにある。いつの時代においても、授業改善は教師に求められることである。教師は、よりよい授業をしたいと願うものの、本質的に授業はおもしろくないものとして、子どもたちには認識されているのが現状である。本研究では、共有ビジョンである「目指す生徒像」を軸とした協働的な授業改善の取り組みを報告する。そして、「目指す生徒像」を教職員が一丸となって作り、解釈、実践、検討していく営みの中で、生徒の実態や授業の問題点を明確に認識し、同じ視点での授業の改善や学校の組織力の向上につながる可能性を見出すこととする。さらに、こうした取り組みを進めていく中で、教師一人ひとりのメンタル・モデルにどのようにアプローチしていくのかということの視座も明らかにしていくこととする。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024高等学校国語科における「語りの場」に着目する学習開発 ―川上弘美「ほねとたね」を教材として―103117ENSotaMOTOMURAGraduate School of Education (Professional Degree Corse), Okayama UniversityShigekoMAKINOFaculty of Education, Okayama UniversityMasafumiIKEDAFaculty of Education, Okayama University10.18926/CTED/66775 近年，文学的文章の読みの学習指導論では，「語り」に目が向けられつつあり，高等学校段階でも授業実践が報告されている。一方で，「語り」の具体的な指導方法の蓄積がなされていないことや，高等学校段階での発展的な「語り」の学習の実践の蓄積がなされていないことが，国語教育研究上の課題と捉えられる。そこで本研究では，高等学校段階において，学習者が「語り」概念，特に「語りの視点」だけでなく「語りの場」にも着目するという読みの観点を学習者が獲得することを目指す実践を開発するとともに，それを実際に展開し，その価値を検証することを目的とした。具体的には，川上弘美の「ほねとたね」を教材とし，学習者の登場人物の好感度の評価や回想文作成を踏まえ，「語りの場」を考える実践を展開しその成果を検討した。その結果，本実践を通して学習者は「語り」概念を獲得するとともに，「語りの視点」，「語りの場」にも着目した読みの達成が示唆された。No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1710-14921912023Successful use of dupilumab for egg-induced eosinophilic gastroenteritis with duodenal ulcer: a pediatric case report and review of literature103ENMitsuruTsugeDepartment of Pediatric Acute Diseases, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesKenjiShigeharaDepartment of Pediatrics, Okayama University HospitalKazuhiroUdaDepartment of Pediatrics, Okayama University HospitalSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University HospitalMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University HospitalYukieSaitoDepartment of Pediatrics, Okayama University HospitalMasatoYashiroDepartment of Pediatrics, Okayama University HospitalMasanoriIkedaDepartment of Pediatrics, Okayama University HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesBackground Non-esophageal eosinophilic gastrointestinal disorder (non-EoE-EGID) is a rare disease in which eosinophils infiltrate parts of the gastrointestinal tract other than the esophagus; however, the number of patients with non-EoE-EGID has been increasing in recent years. Owing to its chronic course with repeated relapses, it can lead to developmental delays due to malnutrition, especially in pediatric patients. No established treatment exists for non-EoE-EGID, necessitating long-term systemic corticosteroid administration. Although the efficacy of dupilumab, an anti-IL-4/13 receptor monoclonal antibody, for eosinophilic esophagitis, has been reported, only few reports have demonstrated its efficacy in non-EoE EGIDs.<br>
Case presentation A 13-year-old boy developed non-EoE-EGID with duodenal ulcers, with chicken eggs as the trigger. He was successfully treated with an egg-free diet, proton pump inhibitors, and leukotriene receptor antagonists. However, at age 15, he developed worsening upper abdominal pain and difficulty eating. Blood analysis revealed eosinophilia; elevated erythrocyte sedimentation rate; and elevated levels of C-reactive protein, total immunoglobulin E, and thymic and activation-regulated chemokines. Upper gastrointestinal endoscopy revealed a duodenal ulcer with marked mucosal eosinophilic infiltration. Gastrointestinal symptoms persisted even after starting systemic steroids, making it difficult to reduce the steroid dose. Subcutaneous injection of dupilumab was initiated because of comorbid atopic dermatitis exacerbation. After 3 months, the gastrointestinal symptoms disappeared, and after 5 months, the duodenal ulcer disappeared and the eosinophil count decreased in the mucosa. Six months later, systemic steroids were discontinued, and the duodenal ulcer remained recurrence-free. The egg challenge test result was negative; therefore, the egg-free diet was discontinued. Blood eosinophil count and serum IL-5, IL-13, and eotaxin-3 levels decreased after dupilumab treatment. The serum levels of IL-5 and eotaxin-3 remained within normal ranges, although the blood eosinophil counts increased again after discontinuation of oral prednisolone.<br>
Conclusions Suppression of IL-4R/IL-13R-mediated signaling by dupilumab may improve abdominal symptoms and endoscopic and histologic findings in patients with non-EoE-EGID, leading to the discontinuation of systemic steroid administration and tolerance of causative foods.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2023Obesity and Dyslipidemia Synergistically Exacerbate Psoriatic Skin InflammationENKentaIKEDAGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.岡山大学教育学部国語研究会Acta Medica Okayama2189-5414372023満洲の現地人向け中国語教科書における「メロスの伝説」(1)(12)ENNo potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231822023高等学校国語科におけるポストモダン絵本を用いた実践像 ―テクストへの意味づけを促すために―1321ENMasafumiIkedaFaculty of Education, Okayama UniversityTomomiTakedaFukuoka Prefectual Genkai High School10.18926/bgeou/64979 本稿では，高等学校国語科において，ポストモダン絵本を教材とした実践開発を行い，具体的な実践像を提示するとともに，その成果を検討することで，その教材性の価値の一端を明らかにすることを目的とした。具体的には，ジョン・シェスカ&レイン・スミスによるポストモダン絵本である『三びきのコブタのほんとうの話』を用い，高等学校三年生を対象に実践を開発した。<br>
結果，本単元の学習によって，読者が自らの立場とは異なる視点に立ったり，語り手の語りに取り込まれないようにしたりするというような読みの視点の獲得がなされていった様子や，主体的にテクストの意味づけを行う様子の具体を示すことができた。またこれらのことを達成できるということが，ポストモダン絵本の教材性の一つとして示唆された。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231802022高等学校国語科におけるICT 活用に必然性がある話し合い指導の開発 ― 学校間の接続による「私的な関係ではない」場の設定 ―3947ENMasafumiIkedaFaculty of Education, Okayama UniversityRyotaMitsugiKumamoto Prefectual Yatsushiro Agricultural High School, Izumi BranchHiraku SatomuraYamaguchi Prefectual Houfu-nishi High School10.18926/bgeou/63922国語教育学研究における話し合い指導は，現実的な制約から教室内の関係の中で展開されるものにとどまっていた。その結果，公的な関係での話し合いの場が設定されにくい現状にあった。しかしながら，ICTの活用を通して学校間を繋ぐことによって，関係性の築き上げられていない関係での話し合いの場の設定が可能になる。そこで，ICTの活用による文字化資料の作成の効率化などの利点も取り入れながら，実際に県を跨いで高等学校間を接続し，話し合いを行うとともに，その話し合いの対象化を行う実践を開発，展開した。結果，学習者は学校間の接続に肯定的な評価を示すとともに，方法知の獲得の土台となるであろう認識を獲得したことを明らかにした。No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2227-9067982022Novel Lung Growth Strategy with Biological Therapy Targeting Airway Remodeling in Childhood Bronchial Asthma1253ENMitsuruTsugeDepartment of Pediatric Acute Diseases, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesMasanoriIkedaOkayama University School of MedicineHirokazuTsukaharaDepartment of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesAnti-inflammatory therapy, centered on inhaled steroids, suppresses airway inflammation in asthma, reduces asthma mortality and hospitalization rates, and achieves clinical remission in many pediatric patients. However, the spontaneous remission rate of childhood asthma in adulthood is not high, and airway inflammation and airway remodeling persist after remission of asthma symptoms. Childhood asthma impairs normal lung maturation, interferes with peak lung function in adolescence, reduces lung function in adulthood, and increases the risk of developing chronic obstructive pulmonary disease (COPD). Early suppression of airway inflammation in childhood and prevention of asthma exacerbations may improve lung maturation, leading to good lung function and prevention of adult COPD. Biological drugs that target T-helper 2 (Th2) cytokines are used in patients with severe pediatric asthma to reduce exacerbations and airway inflammation and improve respiratory function. They may also suppress airway remodeling in childhood and prevent respiratory deterioration in adulthood, reducing the risk of COPD and improving long-term prognosis. No studies have demonstrated a suppressive effect on airway remodeling in childhood severe asthma, and further clinical trials using airway imaging analysis are needed to ascertain the inhibitory effect of biological drugs on airway remodeling in severe childhood asthma. In this review, we describe the natural prognosis of lung function in childhood asthma and the risk of developing adult COPD, the pathophysiology of allergic airway inflammation and airway remodeling via Th2 cytokines, and the inhibitory effect of biological drugs on airway remodeling in childhood asthma.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0918-944013522022Decades-long phylogeographic issues: complex historical processes and ecological factors on genetic structure of alpine plants in the Japanese ArchipelagoENHajimeIkedaInstitute of Plant Science and Resources, Okayama UniversityMountain regions are important places for biodiversity, where organisms could persist throughout prolonged periods and accumulate genetic divergence as well as promote speciation. Roles of mountains for biodiversity have been exclusively discussed in regions that have specifically diverse species or covered with ice-sheets during the Pleistocene glacial periods, whereas the importance of mountainous regions in East Asia has been less disputed. High mountains in the Japanese Archipelago, located at the eastern edge of the Eurasia continent, have one of southernmost populations of alpine and arctic-alpine plants that are also distributed in the northern Pacific and/or the circumarctic regions. Phylogeographic studies on the Japanese alpine plants have excluded their possible ephemeral occurrence during the current warm period, and rather, suggest persistence of alpine plants throughout several cycles of climate changes in the Pleistocene on high mountains in central Honshu, the main island of the Japanese Archipelago. In this review, I look through decade long phylogeographic studies and show complicated patterns of range dynamics of Japanese alpine plants. In addition, I note recent findings of genetic relationships of Japanese populations of alpine and/or arctic-alpine plants with those in northern regions and their possible ecological divergence in the Japanese Archipelago. Taken together, I provide several issues for understanding historical processes that established distribution of alpine plants following climate changes as well as their diversification and propose importance of Japanese populations of alpine plants on biodiversity in alpine communities across broader range, especially in the northern Pacific region.No potential conflict of interest relevant to this article was reported.岡山大学出版会Acta Medica Okayama2018御留帳評定書 目次・凡例・地図・解説EN10.18926/63141No potential conflict of interest relevant to this article was reported.岡山大学出版会Acta Medica Okayama2013朝鮮通信使饗応関係資料 目次・凡例・地図・解説EN10.18926/63140No potential conflict of interest relevant to this article was reported.岡山大学出版会Acta Medica Okayama2010御留帳御船手 目次・凡例・地図・解説EN10.18926/63139No potential conflict of interest relevant to this article was reported.Sage Publications LtdActa Medica Okayama0300-06055012022Severe pediatric asthma with a poor response to omalizumab: a report of three cases and three-dimensional bronchial wall analysis03000605211070492ENMitsuruTsugeDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriIkedaDepartment of Pediatrics, Okayama University HospitalYoichiKondoDepartment of Pediatrics, Matsuyama Red Cross HospitalHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOmalizumab is used for the treatment of persistent severe allergic asthma in adults and children. However, some patients remain symptomatic even after omalizumab treatment. In bronchial asthma, chronic inflammation of the bronchial wall causes thickening of the airway wall, resulting from irreversible airway remodeling. Progression of airway remodeling causes airflow obstruction, leading to treatment resistance. We report three Japanese children with severe asthma who had a poor response to omalizumab treatment. They had a long period of inadequate management of asthma before initiating omalizumab. Even after omalizumab treatment, their symptoms persisted, and the parameters of spirometry tests did not improve. We hypothesized that omalizumab was less effective in these patients because airway wall remodeling had already progressed. We retrospectively evaluated the bronchial wall thickness using a three-dimensional bronchial wall analysis with chest computed tomography. The bronchial wall thickness was increased in these cases compared with six responders. Progressed airway wall thickness caused by airway remodeling may be associated with a poor response to omalizumab in children with severe asthma.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama2227-90678112021Current Insights into Atopic March1067ENMitsuruTsugeDepartment of Pediatric Acute Diseases, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesMasanoriIkedaDepartment of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesNaomiMatsumotoDepartment of Epidemiology, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesTakashiYorifujiDepartment of Epidemiology, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesHirokazuTsukaharaDepartment of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical SciencesThe incidence of allergic diseases is increasing, and research on their epidemiology, pathophysiology, and the prevention of onset is urgently needed. The onset of allergic disease begins in infancy with atopic dermatitis and food allergy and develops into allergic asthma and allergic rhinitis in childhood; the process is defined as "atopic march ". Atopic march is caused by multiple immunological pathways, including allergen exposure, environmental pollutants, skin barrier dysfunction, type 2 inflammation, and oxidative stress, which promote the progression of atopic march. Using recent evidence, herein, we explain the involvement of allergic inflammatory conditions and oxidative stress in the process of atopic march, its epidemiology, and methods for prevention of onset.No potential conflict of interest relevant to this article was reported.岡山大学出版会Acta Medica Okayama2021付録 大寄合之覚書 寛文六年310334EN10.18926/62453No potential conflict of interest relevant to this article was reported.岡山大学出版会Acta Medica Okayama2021御留帳評定書 貞享元年・二年232309EN10.18926/62452No potential conflict of interest relevant to this article was reported.岡山大学出版会Acta Medica Okayama2021御留帳評定書 天和三年145231EN10.18926/62451No potential conflict of interest relevant to this article was reported.岡山大学出版会Acta Medica Okayama2021御留帳評定書 天和二年77144EN10.18926/62450No potential conflict of interest relevant to this article was reported.岡山大学出版会Acta Medica Okayama2021御留帳評定書 天和元年176EN10.18926/62291No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2021Studies on mechanisms of rapid axopodial contraction in the centrohelid Raphidocystis contractilisENRisaIkedaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2021 Clinicopathological analysis of 34 Japanese patients with EBV-positive mucocutaneous ulcerENTomokaIkedaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.Oxford University PressActa Medica Okayama0032-07816182020Life-Course Monitoring of Endogenous Phytohormone Levels under Field Conditions Reveals Diversity of Physiological States among Barley Accessions14381448ENTakashiHirayamaInstitute of Plant Science and Resources, Okayama UniversityDaisukeSaishoInstitute of Plant Science and Resources, Okayama UniversityTakakazuMatsuuraInstitute of Plant Science and Resources, Okayama UniversitySatoshiOkadaInstitute of Plant Science and Resources, Okayama UniversityKotaroTakahagiRIKEN Center for Sustainable Resource ScienceAsakaKanataniRIKEN Center for Sustainable Resource ScienceJunItoKihara Institute for Biological Research, Yokohama City UniversityHiroyukiTsujiKihara Institute for Biological Research, Yokohama City UniversityYokoIkedaInstitute of Plant Science and Resources, Okayama UniversityKeiichiMochidaInstitute of Plant Science and Resources, Okayama UniversityAgronomically important traits often develop during the later stages of crop growth as consequences of various plant–environment interactions. Therefore, the temporal physiological states that change and accumulate during the crop’s life course can significantly affect the eventual phenotypic differences in agronomic traits among crop varieties. Thus, to improve productivity, it is important to elucidate the associations between temporal physiological responses during the growth of different crop varieties and their agronomic traits. However, data representing the dynamics and diversity of physiological states in plants grown under field conditions are sparse. In this study, we quantified the endogenous levels of five phytohormones ― auxin, cytokinins (CKs), ABA, jasmonate and salicylic acid ― in the leaves of eight diverse barley (Hordeum vulgare) accessions grown under field conditions sampled weekly over their life course to assess the ongoing fluctuations in hormone levels in the different accessions under field growth conditions. Notably, we observed enormous changes over time in the development-related plant hormones, such as auxin and CKs. Using 3′ RNA-seq-based transcriptome data from the same samples, we investigated the expression of barley genes orthologous to known hormone-related genes of Arabidopsis throughout the life course. These data illustrated the dynamics and diversity of the physiological states of these field-grown barley accessions. Together, our findings provide new insights into plant–environment interactions, highlighting that there is cultivar diversity in physiological responses during growth under field conditions.No potential conflict of interest relevant to this article was reported. ElsevierActa Medica Okayama1939-455113102020Evaluation of oral immunotherapy efficacy and safety by maintenance dose dependency: A multicenter randomized study100463ENKiyotakeOguraDepartment of Pediatrics, National Hospital Organization, Sagamihara National HospitalNoriyukiYanagidaDepartment of Pediatrics, National Hospital Organization, Sagamihara National HospitalSakuraSatoCourse of Allergy and Clinical Immunology, Juntendo University Graduate School of MedicineTakanoriImaiDepartment of Pediatrics, Showa University School of MedicineKomeiItoDepartment of Allergy, Aichi Children's Health and Medical CenterNaoyukiKandoDepartment of Allergy, Aichi Children's Health and Medical CenterMasanoriIkedaDepartment of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRumikoShibataDepartment of Pediatrics, National Hospital Organization, Fukuoka National HospitalYokoMurakamiDepartment of Pediatrics, National Hospital Organization, Fukuoka National HospitalTakaoFujisawaInstitute for Clinical Research, National Hospital Organization, Mie National HospitalMizuhoNagaoInstitute for Clinical Research, National Hospital Organization, Mie National HospitalNorioKawamotoDepartment of Pediatrics, Graduate School of Medicine, Gifu UniversityNaomiKondoDepartment of Pediatrics, Graduate School of Medicine, Gifu UniversityAtsuoUrisuDepartment of Pediatrics, Fujita Health University, The Second Teaching HospitalIkuyaTsugeDepartment of Pediatrics, Fujita Health University, The Second Teaching HospitalYasutoKondoDepartment of Pediatrics, Fujita Health University, The Second Teaching HospitalKazukoSugaiDepartment of Pediatrics, National Hospital Organization, Yokohama Medical CenterOsamuUchidaDepartment of Pediatrics, National Hospital Organization, Yokohama Medical CenterMitsuyoshiUrashimaDivision of Molecular Epidemiology, The Jikei University School of MedicineMasamiTaniguchiCourse of Allergy and Clinical Immunology, Juntendo University Graduate School of MedicineMotohiroEbisawaCourse of Allergy and Clinical Immunology, Juntendo University Graduate School of MedicineBackground</br>
Generally, oral immunotherapy (OIT) aims for daily administration. Recently, the efficacy of treatment with OIT at a low dose has been reported. However, the optimal dose and the evaluation of dose-dependent OIT outcome have not been described.</br>
Methods</br>
A multicenter, parallel, open-labeled, prospective, non-placebo controlled, randomized study enrolled 101 Japanese patients for treatment with OIT. We hypothesized that target dose OIT would induce short-term unresponsiveness (StU) earlier than reduced dose OIT. StU was defined as no response to 6200 mg whole egg, 3400 mg milk, and 2600 mg wheat protein, as evaluated by oral food challenge after 2-week ingestion cessation. To compare the two doses of OIT efficacy, the maximum ingestion doses during the maintenance phase of OIT were divided into 100%-dose or 25%-dose groups against their target StU dose, respectively. A total of 51 patients were assigned to the 100%-dose group [hen's egg (HE) = 26, cow's milk (CM) = 13, wheat = 12] and 50 to the 25%-dose group (HE = 25, CM = 13, wheat = 12). Primary outcome was established by comparing StU at 1 year. Secondary outcome was StU at 2 years and established by comparing allergic symptoms and immunological changes.</br>
Results</br>
The year 1 StU rates (%) for the 100%- and 25%-dose groups were 26.9 vs. 20.0 (HE), 7.7 vs. 15.4 (CM), and 50.0 vs. 16.7 (wheat), respectively. The year 2 StU rates were 30.8 vs. 36.0 (HE), 7.7 vs. 23.1 (CM), and 58.3 vs. 58.3 (wheat), respectively. There were no statistically significant differences in StU between years 1 and 2. The total allergic symptom rate in the 25%-dose group was lower than that in the 100%-dose group for egg, milk, and wheat. Antigen-specific IgE levels for egg-white, milk, and wheat decreased at 12 months.</br>
Conclusions</br>
Reduced maintenance dose of egg OIT showed similar therapeutic efficacy to the target dose. However, we were not able to clearly demonstrate the efficacy, particularly for milk and wheat. Reducing the maintenance dose for eggs, milk, and wheat may effectively lower the symptoms associated with their consumption compared to the target OIT dose. Furthermore, aggressive reduction of the maintenance dose might be important for milk and wheat, compared to the 25%-dose OIT.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama132389306932020Japanese guidelines for atopic dermatitis 2020.356369ENNoritoKatohDepartment of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical ScienceYukihiroOhyaAllergy Center, National Center for Child Health and DevelopmentMasanoriIkedaDepartment of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTamotsuEbiharaDepartment of Dermatology, Keio University School of MedicineIchiroKatayamaDepartment of Dermatology, Graduate School of Medicine, Osaka UniversityHidehisaSaekiDepartment of Dermatology, Graduate School of Medicine, Nihon Medical SchoolNaokiShimojoDepartment of Pediatrics, Graduate School of Medicine, Chiba UniversityAkioTanakaDepartment of Dermatology, Hiroshima University Graduate School of Biomedical SciencesTakeshiNakaharaDivision of Skin Surface Sensing, Department of Dermatology, Graduate School of Medical Sciences, Kyushu UniversityMizuhoNagaoDivision of Clinical Research, National Hospital Organization Mie National HospitalMichihiroHideDepartment of Dermatology, Hiroshima University Graduate School of Biomedical SciencesYujiFujitaDepartment of Pediatrics, Graduate School of Medicine, Chiba UniversityTakaoFujisawaDivision of Allergy, National Hospital Organization Mie National HospitalMasakiFutamuraDivision of Pediatrics, National Hospital Organization Nagoya Medical CenterKojiMasudaDepartment of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical ScienceHiroyukiMurotaDepartment of Dermatology, Nagasaki University Graduate School of Biomedical SciencesKiwakoYamamoto-HanadaAllergy Center, National Center for Child Health and DevelopmentAtopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion, which is frequently encountered in clinical practice. Skin barrier dysfunction leads to enhanced skin irritability to non-specific stimuli and epicutaneous sensitization. In the lesion site, a further inflammation-related reduction in skin barrier function, enhanced irritability and scratching-related stimuli deteriorate eczema, leading to vicious cycle of inflammation. The current strategies to treat AD in Japan from the perspective of evidence-based medicine consist of three primary measures: (i) the use of topical corticosteroids and tacrolimus ointment as the main treatment for the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling and advice about daily life. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice. No potential conflict of interest relevant to this article was reported.Oxford University PressActa Medica Okayama003207816132019Regulation of the Poly(A) Status of Mitochondrial mRNA by Poly(A)-Specific Ribonuclease Is Conserved among Land Plants470480ENMaiKanazawaDivision of Science for Bioresources, Graduate School of Environment and Life Science, Okayama UniversityYokoIkedaDivision of Science for Bioresources, Graduate School of Environment and Life Science, Okayama UniversityRyuichiNishihamaGraduate School of Biostudies, Kyoto UniversityShoheiYamaokaGraduate School of Biostudies, Kyoto UniversityNam-HeeLeeDepartment of Life Sciences, Faculty of Science and Engineering, Sorbonne UniversityKatsuyuki TYamatoDepartment of Biotechnological Science, Faculty of Biology-Oriented Science and Technology, Kindai UniversityTakayukKohchiGraduate School of Biostudies, Kyoto UniversityTakashiHirayamaDivision of Science for Bioresources, Graduate School of Environment and Life Science, Okayama UniversityRegulation of the stability and the quality of mitochondrial RNA is essential for the maintenance of mitochondrial and cellular functions in eukaryotes. We have previously reported that the eukaryotic poly(A)-specific ribonuclease (PARN) and the prokaryotic poly(A) polymerase encoded by AHG2 and AGS1, respectively, coordinately regulate the poly(A) status and the stability of mitochondrial mRNA in Arabidopsis. Mitochondrial function of PARN has not been reported in any other eukaryotes. To know how much this PARN-based mitochondrial mRNA regulation is conserved among plants, we studied the AHG2 and AGS1 counterparts of the liverwort, Marchantia polymorpha, a member of basal land plant lineage. We found that M. polymorpha has one ortholog each for AHG2 and AGS1, named MpAHG2 and MpAGS1, respectively. Their Citrine-fused proteins were detected in mitochondria of the liverwort. Molecular genetic analysis showed that MpAHG2 is essential and functionally interacts with MpAGS1 as observed in Arabidopsis. A recombinant MpAHG2 protein had a deadenylase activity in vitro. Overexpression of MpAGS1 and the reduced expression of MpAHG2 caused an accumulation of polyadenylated Mpcox1 mRNA. Furthermore, MpAHG2 suppressed Arabidopsis ahg2-1 mutant phenotype. These results suggest that the PARN-based mitochondrial mRNA regulatory system is conserved in land plants.No potential conflict of interest relevant to this article was reported.HindawiActa Medica Okayama0278-02402018Serum Procalcitonin Levels in Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion2380179ENYosukeFujiiDepartment of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoYashiroDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMutsukoYamadaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomonobuKikkawaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuyukiNosakaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukieSaitoDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiTsukaharaDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry andMasanoriIkedaDepartment of Pediatric Acute Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTsuneoMorishimaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokazuTsukaharaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesProcalcitonin (PCT) is used as a biomarker in severe infections. Here, we retrospectively investigated levels of serum PCT, C-reactive protein (CRP), and inflammatory cytokines (IL-6, TNF-alpha, and IFN-gamma) in the second phase of patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). Nine AESD pediatric patients (4 men, 5 women; AESD group) admitted to Okayama University Hospital from 2010 to 2016 were compared with 10 control patients with febrile seizures (FS) (3 men, 7 women; FS group). Mean PCT concentrations (ng/mL) in the AESD and FS groups were significantly different, at 9.8 +/- 6.7 and 0.8 +/- 0.9, respectively (p = 0 0006). CRP (mg/dL) were 0.79 +/- 0.89 and 1.4 +/- 1.0 (p = 0 94), respectively; IL-6 (pg/mL) were 449.7 +/- 705.0 and 118.3 +/- 145.4 (p = 0 20), respectively; TNF-alpha (pg/mL) were 18.6 +/- 12.5 and 16.6 +/- 6.0 (p = 0 67), respectively; and IFN-gamma (pg/mL) were 79.6 +/- 158.5 and 41.9 +/- 63.7 (p = 0 56), respectively. Ratios of PCT to CRP were 27.5 +/- 34.2 and 3.2 +/- 6.8 (p < 0 0001), respectively. The sensitivity and specificity in the diagnosis of AESD using a cutoff of PCT/CRP ratio of 1.0 were 79% and 100%, respectively. These results suggest that PCT and the PCT/CRP ratio are useful in auxiliary diagnosis of the second stage of AESD, and in AESD, PCT is likely to increase through a different mechanism.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2019Predictive Factors for Successful Vaccination Against Hepatitis B Surface Antigen in Patients Who Have Undergone Orthotopic Liver TransplantationENAiriIkedaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama342018無腸動物Praesagittifera naikaiensis における細胞骨格要素2127ENRisaIkedaGraduate School of Education, Okayama UniversityChihoFujiwaraGraduate School of Education, Okayama UniversityMayukoHamadaUshimado Marine Institute, Faculty of Science, Okayama UniversityTatsuyaSakamotoUshimado Marine Institute, Faculty of Science, Okayama UniversityNoboruSaitoGraduate School of Environmental and Life Science, Okayama UniversityMotonoriAndoGraduate School of Education, Okayama UniversityAcoel flatworms can move in a variety of ways such as muscular and ciliary movements via cytoskeletal elements and their neural regulations. However, those locomotive mechanisms have not yet been fully elucidated. In this study, we examined the distribution of cytoskeletal elements including filamentous actin (F-actin) and tubulin, and the neuroanatomical organization in an acoelomorph worm, Praesagittifera naikaiensis (P. naikaiensis). Video microscopy revealed the elongation/contraction and the bending/rotation processes, and the ciliary gliding movement of P. naikaiensis. Histochemical and morphological analysis demonstrated that F-actin networks of inner longitudinal and outer circular muscle fibers were positioned along the entire surface of the body, and that the average distance between the circular muscle fibers in the contracted organism was decreased in the anterior region compared with that in the elongated organism. Electron microscopy showed dense bodies on the muscle cells of P. naikaiensis, which indicates that those muscle cells have the appearance of vertebrate smooth muscle cells. Immunohistochemical analysis revealed that -tubulin-positive signals on the ciliary microtubules had close contact with the F-actin network, and that neurite bundles labelled with anti dSap47 antibody as a neuronal marker run along the anterior-posterior body axis. These results indicate that the well-organized cytoskeletal elements and their neural control systems are preserved in P. naikaiensis, and that their mechanisms involved in those regulation systems are similar to those vertebrate systems. Further studies are needed to clarify the physiological mechanisms underlying the muscular and ciliary movements in P. naikaiensis.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2018Functional peptide KP24 enhances submandibular gland tissue growth in vitroENAtsushiIkedaOkayama UniversityNo potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966522017台湾人元留学生の職場における自己の存在意義と職場の意味135150ENTomomiMoriyaInstitute for Education and Student Services, Okayama UniversityKaorukoWadaSeikoIkedaTomiyoKagami10.18926/55722 本研究の目的は、近年増加傾向にある日本留学を経て日本企業に就職した台湾人元留学生を対象とし、職場における自己の存在意義と自分の職場の意味をどのように捉えているかを質的な分析を通して解明することである。就労開始後10 年以内の台湾人元大学院留学生9 名を対象に半構造化インタビューを実施し、KJ 法を援用し分析を行った結果、自己の存在意義計29 件、職場の意味計31 件が抽出された。この結果から、本調査対象者は、多文化就労場面における元留学生である自己の存在意義を見出せるケースと見出せないケースが拮抗していること、また、自分の職場を概ね肯定的に捉えているものの、同時に二律背反的な見方が一個人の中に併存することが示された。No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812932017平成28年度岡山医学会賞 脳神経研究奨励賞（新見賞）167169ENChikakoIkeda Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2017A rapid and precise method for measuring plasma apoE-rich HDL using polyethylene glycol and cation-exchange chromatography: a pilot study on the clinical significance of apoE-rich HDL measurements.ENToruIkedaGraduate School of Health Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231652017岡山後楽園の水車と延養亭前手水鉢の関係試論4346ENKenSahashiOkayama University Graduate School of Education10.18926/bgeou/55292 日本三名園の一つに数えられている岡山後楽園には水車が回っている。他に水車のある日本庭園があるかどうか，あまり例を聞かない。何の為に水車があるのか？ 筆者はその水車に歴史的，心理的な光でなく，科学的な光を当ててみようとした。水車・底樋・手水鉢の三つの部品を組み合わせた日本初の新しい暑気払いの為の装置ではなかったのか，との発見をしたように思うので，ここで議論の材料として提出したい。詳細な内容については別途機会を得て提出する。No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1351-51012052013A novel familial prion disease causing pan-autonomic-sensory neuropathy and cognitive impairmente67e69ENKosukeMatsuzonoYoshioIkedaDepartment of Neurology, Okayama University Graduate School of Medicine and DentistryWentaoLiuTomokoKurataDepartment of Neurology, Okayama University Graduate School of Medicine and DentistryShokoDeguchiKentaroDeguchiDepartment of Neurology, Okayama University Graduate School of Medicine and DentistryKojiAbeDepartment of Neurology, Okayama University Graduate School of Medicine and DentistryNo potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama332017鳥類内耳tegmentum vasculosum の構造と機能2630ENRisaIkedaLaboratory of Cell Physiology, Department of Science Education, Graduate School of Education, Okayama UniversityTsuyoshiOtonoLaboratory of Cell Physiology, Department of Science Education, Graduate School of Education, Okayama UniversityNaoyaIkedaLaboratory of Cell Physiology, Department of Science Education, Graduate School of Education, Okayama UniversityNoboruSaitoLaboratory of Animal Physiology and Pharmacology, Department of Animal Science, Graduate School of Environmental and Life Science, Okayama UniversityMotonoriAndoLaboratory of Cell Physiology, Department of Science Education, Graduate School of Education, Okayama University In spite of the importance of endocochlear DC potential (EP) and the K+-rich endolymph for the avian cochlea, the structure and function of the tegmentum vasculosum (TV) has not yet been fully elucidated, compared with those of the stria vascularis in the mammalian cochlea. In this study, we examined structural analysis of the epithelial cells, gene expressions of Na+-K+-ATPase (Atp1A1) and Kir4.1 (Kcnj10), and protein localizations of Na+-K+-ATPase and Kir4.1, in the TV. Tight junctional structures were observed between epithelial dark cells and light cells in the TV. Both Atp1a1 and Kcnj10 genes were detected in the TV. In addition, immunopositive signals for both Na+-K+-ATPase and Kir4.1 were recognized in the TV. These results indicate that Na+-K+-ATPase and Kir4.1 play roles in maintaining the EP and high K+ concentration of the endolymph. Further studies are needed to clarify the physiological functions of the TV. This is the first report which demonstrates that gene and protein expression data contribute to the avian inner ear homeostasis.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812912017骨盤臓器脱に対するTVM 手術前後の性機能に関する検討1722ENYukoMatsumotoDepartment of Urology, Okayama University Graduate School of Medicne, Dentistry and Pharmaceutical Sciences We prospectively assessed sexual function before and after a tension-free vaginal mesh ( TVM) procedure for pelvic organ prolapse ( POP) . From April 2007 to March 2009, a total of 42 patients, who reported having an active sex life preoperatively underwent TVM for POP. Female sexual function was evaluated with the self-reporting, multiple-domain Female Sexual Function Index (FSFI) . We administered the FSFI to all of the patients before and at 3, 6, and 12 months after surgery. The mean age at surgery was 61.3±7.1 years. Before the TVM surgery, the FSFI score was very low ( 12.5±9.0) . The total FSFI score was improved significantly at 12 months after surgery ( 17.4±7.7) . The Arousal, Lubrication and Orgasm domains were significantly improved at 12 months after surgery. POP appears to have a significant negative impact on female sexual function. Our findings indicate that TVM for POP improved sexual function in a group of Japanese women with POP.No potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama0285-4864652016友人を開示者としたオープナー・スキル尺度（大学生版）の開発2937ENTakashiHoriuchiNaokoYamasakiKeikoIkeda10.18926/okadai-bun-kiyou/54784No potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671422016『せん年より御ふれふみ』『大坂岡山御触留』で補われる江戸時代大阪出版法令について ―附、岡山大学附属図書館池田家文庫蔵『宝暦三癸酉八月ヨリ大坂岡山御触留』 所収大阪触達番号一覧―(21)(35)ENHidekiYamamoto10.18926/54684No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2016The Relationship Between Development of Neuronal and Astrocytic Tau Pathologies in Subcortical Nuclei and Progression of Argyrophilic Grain DiseaseENChikakoIkedaNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558128320163 年間の内視鏡所見の変化を観察できた食道異所性皮脂腺の1 例201205ENMasayaIwamuroDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeitaHaradaDepartment of Endoscopy, Okayama University HospitalHiromitsuKanzakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeisukeHoriDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahideKitaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSeijiKawanoDepartment of Endoscopy, Okayama University HospitalYoshiroKawaharaDepartment of Endoscopy, Okayama University HospitalTakehiroTanakaDepartment of Pathology, Okayama University HospitalKazuhideYamamotoDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences A 43-year-old Japanese woman was diagnosed with ectopic sebaceous glands in the esophagus by esophagogastroduodenoscopy and biopsy. At the age of 46, typical ectopic sebaceous glands were recognized in the upper esophagus, whereas yellowish white granules were faintly observed in the lower esophagus. Esophagogastroduodenoscopy examinations were repeated when she was 47 and again at 50 years old, and the lesions in the lower esophagus had become more evident over the ensuing 3 years. Esophageal ectopic sebaceous glands are relatively infrequent, and there have been few case reports describing the progression of the endoscopic features. We also report the clinical and endoscopic features of the five similar cases with pathologically proven ectopic sebaceous glands in the esophagus.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2016癌関連遺伝子の同定のための計算手法の確立ENMasashiIkedaNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7012016Entecavir Reduces Hepatocarcinogenesis in Chronic Hepatitis B Patients112ENTetsuyaYasunakaFusaoIkedaNozomuWadaYukiMorimotoShin-ichiFujiokaJunichiToshimoriHaruhikoKobashiKazuyaKariyamaYoichiMorimotoHirokiTakayamaTomonoriSenoKoichiTakaguchiAkioMoriyaHirokazuMiyatakeRyoichiOkamotoKazuhisaYabushitaAkinobuTakakiKazuhideYamamotoOriginal Article10.18926/AMO/53996Chronic hepatitis B (CHB) leads to cirrhosis and hepatocellular carcinoma (HCC). With a cohort of 1,206 CHB patients who visited Okayama University Hospital and related hospitals in 2011 and 2012, we compared the incidence rates of HCC among the patients grouped by age, hepatitis B virus (HBV) DNA, hepatitis B e antigen (HBeAg), and treatment. HCCs were observed in 115 patients with the median observation period of 1,687 days. Among the HCC patients aged ≥ 35 years, HBV DNA ≥ 4 log copies/mL and positive HBeAg at diagnosis (n=184), the HCC incidence rate was 8.4% at 5 years in the entecavir (ETV)-treated patients, 21.8% in the lamivudine (LVD)-treated patients, and 26.4% among the patients not treated with drugs. The cumulative HCC incidence was significantly reduced in the ETV-treated patients compared to those treated with LVD or not treated (p=0.013). Among the patients aged ≥ 35 years with HBV DNA ≥ 4 log copies/mL and negative HBeAg (n=237), the cumulative HCC incidence was 14.6% in 5 years in ETV group and 13.9% among those not treated with a drug (p>0.05). Only small numbers of HCCs occurred in other patients. In CHB patients aged≥35 years with HBV DNA ≥4 log copies/mL and positive HBeAg, ETV treatment is recommended for the suppression of HCC development.No potential conflict of interest relevant to this article was reported.Nature Publishing GroupActa Medica Okayama2045-232262016Insufficiency of phosphatidylethanolamine N-methyltransferase is risk for lean non-alcoholic steatohepatitis21721ENAtsukoNakatsukaMakotoMatsuyamaSatoshiYamaguchiAkihiroKatayamaJunEguchiKazutoshiMurakamiSanaeTeshigawaraDaisukeOgawaNozomuWadaTetsuyaYasunakaFusaoIkedaAkinobuTakakiEijiroWatanabeJunWada Although obesity is undoubtedly major risk for non-alcoholic steatohepatitis (NASH), the presence of lean NASH patients with normal body mass index has been recognized. Here, we report that the insufficiency of phosphatidylethanolamine N-methyltransferase (PEMT) is a risk for the lean NASH. The Pemt−/− mice fed high fat-high sucrose (HFHS) diet were protected from diet-induced obesity and diabetes, while they demonstrated prominent steatohepatitis and developed multiple liver tumors. Pemt exerted inhibitory effects on p53-driven transcription by forming the complex with clathrin heavy chain and p53, and Pemt−/− mice fed HFHS diet demonstrated prominent apoptosis of hepatocytes. Furthermore, hypermethylation and suppressed mRNA expression of F-box protein 31 and hepatocyte nuclear factor 4α resulted in the prominent activation of cyclin D1. PEMT mRNA expression in liver tissues of NASH patients was significantly lower than those with simple steatosis and we postulated the distinct clinical entity of lean NASH with insufficiency of PEMT activities.No potential conflict of interest relevant to this article was reported.Nature Publishing GroupActa Medica Okayama2045-232252015Beneficial impact of Gpnmb and its significance as a biomarker in nonalcoholic steatohepatitis16920ENAkihiroKatayamaAtsukoNakatsukaJunEguchiKazutoshiMurakamiSanaeTeshigawaraMotokoKanzakiTomokazuNunoueKazuyukiHidaNozomuWadaTetsuyaYasunakaFusaoIkedaAkinobuTakakiKazuhideYamamotoHiroshiKiyonariHirofumiMakinoJunWadaNonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide. Gpnmb is classified as a type 1 membrane protein and its soluble form is secreted by ADAM10-mediated cleavage. Gpnmb mRNA was found in the Kupffer cells and white adipose tissues (WATs) and its upregulation in obesity was recently found. Here, we generated aP2 promoter-driven Gpnmb transgenic (Tg) mice and the overexpression of Gpnmb ameliorated the fat accumulation and fibrosis of the liver in diet-induced obesity model. Soluble form of Gpnmb in sera was elevated in Gpnmb Tg mice and Gpnmb concentrated in hepatic macrophages and stellate cells interacted with calnexin, which resulted in the reduction of oxidative stress. In the patients with non-alcoholic steatohepatitis, serum soluble GPNMB concentrations were higher compared with the patients with simple steatosis. The GPNMB is a promising biomarker and therapeutic target for the development and progression of NAFLD in obesity.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6942015Effectiveness of Extending Treatment Duration in Therapy with Pegylated Interferon and Ribavirin for Genotype 2 Hepatitis C Virus Infection237244ENShintarouNanbaFusaoIkedaShin-ichiFujiokaYasuyukiArakiKouichiTakaguchiNoriakiHashimotoHiroyukiSekiAkinobuTakakiYoshiakiIwasakiKazuhideYamamotoOriginal Article10.18926/AMO/53560The effectiveness of extending treatment duration as response guided therapy was previously reported for chronic hepatitis C (CHC) genotype 1, but is still controversial for genotype 2. The present study is a retrospective cohort study to investigate the effectiveness of extending treatment duration in therapy with pegylated interferon and ribavirin for patients with CHC genotype 2 by focusing on the timing at which patients obtained undetectable HCV RNA. A total of 306 patients who obtained undetectable HCV RNA by week 24 of treatment and completed 24 weeks of treatment were enrolled. Rapid virological response (RVR) to standard therapy was achieved by 122 patients (51ｵ), and 89ｵ of them obtained sustained virological response (SVR), while 69ｵ of non-RVR patients achieved SVR. Non-RVR patients with undetectable HCV RNA at week 8, and insufficient adherence＜80ｵ pegylated interferon and ribavirin during the first 24 weeks, significantly improved their SVR rate by extended therapy. Among patients receiving extended therapy, drug adherences did not differ between SVR and non-SVR patients, indicating that extending treatment duration might compensate for insufficient antiviral effects due to insufficient drug adherences. This finding might be useful in creating a guideline for extending treatment duration for patients with CHC genotype 2.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6942015Local Recurrence and Complications after Percutaneous Radiofrequency Ablation of Hepatocellular Carcinoma : A Retrospective Cohort Study Focused on Tumor Location219226ENJunichiToshimoriKazuhiroNousoShinichiroNakamuraNozomuWadaYukiMorimotoYasutoTakeuchiTetsuyaYasunakaKenjiKuwakiHidekiOhnishiFusaoIkedaHidenoriShirahaAkinobuTakakiKazuhideYamamotoOriginal Article10.18926/AMO/53558We conducted a retrospective cohort study to investigate the predisposing factors for local recurrence and complications after percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). HCC patients (n＝397) consecutively treated with RFA (256 males, 141 females, median age 69 years) were enrolled. In these patients, 1,455 nodules (median size 17mm) were ablated. Predisposing factors for overall recurrence and local recurrence in the context of tumor location and complications were examined. Local recurrence was observed for 113 of the 1,455 nodules. The 1-, 3- and 5-year local recurrence rates were 2.2ｵ, 7.4ｵ and 9.5ｵ, respectively. A multivariate Cox proportional hazard analysis revealed that large tumor size (＞2cm), tumor location (adjacent to the major portal branch or hepatic vein), and small ablated margin (＜3mm) were independent predisposing factors for local recurrence after RFA (HR＝1.70-2.81). Tumor location (adjacent to the major portal branch, hepatic vein, or diaphragm) was also revealed as a risk factor for liver damage due to RFA. HCC adjacent to the major portal vein or hepatic vein was associated with a higher risk for local recurrence and for complications;therefore, special precautions are necessary when applying RFA to HCC near vessels even when the tumors are located at an easy-to-puncture site.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812722015腹腔鏡内視鏡合同手術（Laparoscopy and Endoscopy Cooperative Surgery；LECS） を施行したＳ状結腸膀胱瘻の1例123126ENHiroshiKatoMasahiroOishiMasahitoKoderaMasaoYamamuraHideakiIkedaKenjiMizunoYumaTaniYutakaYamashitaShunjiHayataTakushiKurashigeYasuhiroNishiyamaDaisukeNishikawaWe performed laparoscopic and endoscopic cooperative surgery (LECS) for partial colectomy with partial cystectomy in an 80-year-old woman with sigmoidovesical fistula secondary to sigmoid diverticulitis. LECS was designed for local resection of the stomach for gastric submucosal tumors using the endoscopic submucosal dissection (ESD) technique. While conventional open abdominal surgery is very invasive, LECS has enabled surgeons to perform minimally invasive surgery. Although there have been no reported cases in which the bladder was laparoscopically resected after sigmoidovesical fistula division, we were able to safely resect the fistula and preserve the urethral opening by performing laparoscopic and cystoscopic cooperative surgery. There are no previously reported cases in which LECS was performed for partial sigmoidectomy and partial cystectomy ; therefore, we report this as a valuable case, with a review of the literature. We hope that further studies involving more patients will lead to the establishment of this procedure.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6932015Aberrant Expression of Keratin 7 in Hepatocytes as a Predictive Marker of Rapid Progression to Hepatic Failure in Asymptomatic Primary Biliary Cirrhosis137144ENHiroyukiSekiFusaoIkedaShintaroNanbaYukiMoritouYasutoTakeuchiTetsuyaYasunakaHidekiOnishiYasuhiroMiyakeAkinobuTakakiKazuhiroNousoYoshiakiIwasakiMinoruNakamuraKazuhideYamamotoOriginal Article10.18926/AMO/53520A predictive marker of the rapid progression to hepatic failure is desired for patients with asymptomatic primary biliary cirrhosis (aPBC). We performed a systematic cohort analysis of 101 patients diagnosed as having aPBC and the rapid progression to liver failure in some, by focusing on cholestasis. Cholestasis was assessed by aberrant keratin7 (K-7) expressions in the patientsʼ hepatocytes. Intralobular expressions of K-7 were found in 9 of the 101 patients. The grades of K-7 expression were significantly associated with the levels of alanine aminotransferase, alkaline phosphatase, and total bilirubin at the time of diagnosis, but not with bile duct loss or cholestasis. Stepwise logistic regression analysis revealed that high grades of K-7 expression correlated positively with high levels of total bilirubin. During the follow-up period, 8 patients developed jaundice, and the mean period until the development of jaundice was 5.2 years. The proportional hazards models for the risk of developing jaundice identified a high grade of aberrant K-7 expression in hepatocytes as the only significant risk factor. Aberrant K-7 expression in hepatocytes can be used as an additional marker to predict rapid progression to liver failure in patients with aPBC at the time of diagnosis.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812712015家族性大腸腺腫症（FAP）に合併した同時性５多発大腸癌に対してリンパ節郭清を伴う腹腔鏡下大腸全摘術を施行した１例2529ENHiroshiKatoMasahiroOishiMasahitoKoderaMasaoYamamuraHideakiIkedaKenjiMizunoYutakaYamashita A 49-year-old Japanese man visited our hospital with chief complaints of difficulty with and bleeding during defecation. After a detailed examination, he was diagnosed with familial adenomatous polyposis (FAP) with multiple (five) colorectal cancers. The tumors were located in the right-sided, left-sided, and sigmoid colon, and the lower rectum. Regional lymph node involvement was observed, but no metastasis to other organs was detected. We, therefore, performed a laparoscopic total colectomy with superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) lymph node dissection. We were able to perform minimally invasive and cosmetically acceptable surgery using laparoscopy instead of highly-invasive open abdominal surgery. Our search of the literature revealed no reported cases of laparoscopic total colectomy with lymph node dissection for FAP with multiple colorectal cancers, making the present case the first to be reported in the literature.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231582015「御鞠場」がある池田家文庫絵図の発見（短報）115118ENKenSahashi10.18926/bgeou/53156 岡山大学図書館が管理する「池田家文庫」の絵図を調べるうち，今までその存在が曖昧で
あった蹴鞠場の位置を明確に示す絵図を発見した。その絵図そのものは，すでに後楽園の歴
史の解説書などにも使用されているものであったが，なぜか「御鞠場」に誰も注目していな
かった。池田家文庫では絵図は原則として「Ｔ７」という項目に分類されており，その中に
は後楽園の敷地内全体の建物配置が分かる情報を含む絵図も何枚かあることは良く知られて
いたが，「Ｔ７」以外の分類項目の中からも，同様の情報が得られる絵図があるかも知れな
いとの期待のもとに，検索範囲を広げた結果，「Ｔ６」の中に「御鞠場」と記された建物が
存在する絵図があった。また，その絵図の成立推定年は池田家文庫では未詳とされているが，
早くて1786 年，遅くても1815 年という結果が得られたので報告する。No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0944-117445112010Laparoscopic findings of reddish markings predict hepatocellular carcinoma in patients with hepatitis B virus-related liver disease11721182ENBonShojiFusaoIkedaShin-ichiFujiokaHaruhikoKobashiTetsuyaYasunakaYasuhiroMiyakeHidenoriShirahaAkinobuTakakiKazuhiroNousoYoshiakiIwasakiKazuhideYamamotoFor patients with chronic hepatitis due to hepatitis B virus (HBV), factors predicting hepatocellular carcinoma (HCC) other than high levels of HBV-DNA and alanine aminotransferase (ALT) are needed to prevent HCC development, as many patients with chronic HBV infection fulfill these conditions. The purpose of this study was to clarify factors predictive of HCC development for those patients.
The study was a systematic cohort analysis of 303 consecutive patients with hepatitis B e-antigen, receiving laparoscopic examination for assessment of liver disease. Laparoscopic, histological, and clinical characteristics were investigated as related to HCC development.
HCC occurred in 27 patients during a mean follow-up of 8.0 +/- A 5.0 years, at the age of 37-72 years. Significant associations with HCC development were shown for liver cirrhosis, histological activity grade, reddish markings, and older age. Multivariate analysis revealed that HCC development was strongly associated with older age and male gender (P = 0.002 and P = 0.043, respectively). HCC occurred more frequently in patients of age a parts per thousand yen30 years even with early stage than in patients of age < 30 years (P = 0.031). Severe reddish markings, a laparoscopic finding of widespread parenchymal destruction, were highly associated with HCC development in patients of age a parts per thousand yen30 years at diagnosis (odds ratio = 1.67, P = 0.034), while histological activity grade and ALT level were not (P = 0.075 and P = 0.69, respectively).
HCC development is associated with older age, male gender, and liver cirrhosis. Reddish markings, rather than histological activity or ALT level, can be useful to predict HCC for HBV patients of age a parts per thousand yen30 years.No potential conflict of interest relevant to this article was reported.Public Library ScienceActa Medica Okayama1932-6203972014L-Carnitine Prevents Progression of Non-Alcoholic Steatohepatitis in a Mouse Model with Upregulation of Mitochondrial PathwayENHisashiIshikawaAkinobuTakakiRyuichiroTsuzakiTetsuyaYasunakaKazukoKoikeYasuyukiShimomuraHiroyukiSekiHiroshiMatsushitaYasuhiroMiyakeFusaoIkedaHidenoriShirahaKazuhiroNousoKazuhideYamamotoNon-alcoholic steatohepatitis (NASH) is a severe form of non-alcoholic fatty liver disease characterized by lobular inflammation, hepatocellular ballooning, and fibrosis with an inherent risk for progression to cirrhosis and hepatocellular carcinoma (HCC). Mitochondrial dysfunction appears to play a role in the progression from simple steatosis to NASH. L-carnitine (L-b-hydroxy-g-N-trimethylaminobutyric acid), an essential nutrient that converts fat into energy in mitochondria, has been shown to ameliorate liver damage. The aim of the present study was to explore the preventive and therapeutic effect of L-carnitine in NASH model mice. Eight-week-old male STAM mice, a NASH-cirrhosis-hepatocarcinogenic model, were divided into 3 experimental groups and fed as follows: 1) high-fat diet (HFD) (control group); 2) HFD mixed with 0.28% L-carnitine (L-carnitine group); and 3) HFD mixed with 0.01% alpha-tocopherol (alpha-tocopherol group). After 4 or 8 weeks, mice were sacrificed. Blood samples and livers were collected, and hepatic tumors were counted and measured. Livers were subjected to histological study, immunohistochemical staining of 4-hydroxynonenal and ferritin, determination of 8-OHdG levels, mRNA and protein expressions for multiple genes, and metabolomic analysis. The intestinal microbiome was also analyzed. L-carnitine increased hepatic expression of genes related to long-chain fatty acid transport, mitochondrial beta-oxidation, and antioxidant enzymes following suppression of hepatic oxidative stress markers and inflammatory cytokines in NASH, and mice treated with L-carnitine developed fewer liver tumors. Although alpha-tocopherol resulted in NASH improvement in the same manner as L-carnitine, it increased periodontitis-related microbiotic changes and hepatic iron transport-related gene expression and led to less effective for anti-hepatocarcinogenesis. Conclusion: L-carnitine prevents progression of non-alcoholic steatohepatitis in a mouse model by upregulating the mitochondrial beta-oxidation and redox system.No potential conflict of interest relevant to this article was reported.岡山大学農学部Acta Medica Okayama2186-77551042015部位特異的変異によるピラノース酸化酵素の色素依存性脱水素酵素活性の向上14ENToshioArakiTomokoNakatsukaTakashiTamuraKenjiInagaki Pyranose oxidase (EC 1.1.3.10 ; PROD) catalyzes the oxidation of aldopyranoses at the position C‒2
to yield the corresponding 2‒keto-aldoses and H2O2 , using oxygen as an electron acceptor. The enzyme shows broad substrate specificity as well as reactivity for 1,5‒anhydro‒d‒glucitol (1,5‒AG), which is known as a clinical glycemic marker. It is considered that the reactivity of PROD for 1,5‒AG is useful in the development of an amperometric-type biosensor, which is a convenient diagnostic device for selfmonitoring
blood glucose (SMBG). However, the levels of dissolved oxygen in blood affect biosensor
systems that are equipped with an artificial electron mediator. In the present study, we attempted to develop an O2‒insensitive oxidase that would improve the dye-mediated dehydrogenase activity. We performed site-directed mutagenesis on PROD isolated from basidiomycetous fungus No. 52, which generated 11 mutants. The amino acid substitution Q421A exhibited a significant decrease (8.8% of wild type) in its oxidase activity, whereas it maintained its dehydrogenase activity (67% of wild type). In this study, we characterized PROD mutants from basidiomycetous fungus No. 52, which showed improved dye-mediated dehydrogenase activity.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0944-11744832013The impact of patatin-like phospholipase domain-containing protein 3 polymorphism on hepatocellular carcinoma prognosis405412ENYasutoTakeuchiFusaoIkedaYukiMoritouHiroakiHagiharaTetsuyaYasunakaKenjiKuwakiYasuhiroMiyakeHidekiOhnishiShinichiroNakamuraHidenoriShirahaAkinobuTakakiYoshiakiIwasakiKazuhiroNousoKazuhideYamamotoThe single nucleotide polymorphism (SNP) rs738409 in patatin-like phospholipase domain-containing protein 3 (PNPLA3) is associated with hepatic fat accumulation and disease progression in patients with non-alcoholic fatty liver disease and alcoholic liver disease (ALD). This study was conducted to determine whether PNPLA3 rs738409 SNPs affect development and prognosis of hepatocellular carcinoma (HCC) in patients with various liver diseases.
We enrolled 638 consecutive Japanese patients newly diagnosed with HCC between 2001 and 2010: 72 patients with hepatitis B virus (HBV), 462 with hepatitis C virus (HCV), and 104 with non-B non-C (NBNC).
NBNC patients exhibited large tumors of advanced TNM stages at HCC diagnosis, and had significantly poorer prognosis than HBV or HCV patients (P < 0.001 and < 0.001, respectively; log-rank test). The G/G genotype of PNPLA3 rs738409 SNP had significantly higher distribution in NBNC patients (P < 0.001) and was significantly associated with higher body mass index (BMI) and an increased aspartate aminotransferase to platelet ratio index. No significant differences were observed in survival with differences in PNPLA3 SNP genotypes among the patients, although ALD patients with the G/G genotype of PNPLA3 SNP and low BMI had significantly poorer survival than those with high BMI (P = 0.028).
The G/G genotype of PNPLA3 rs738409 SNP was more frequently distributed, and associated with BMI and fibrosis among NBNC-HCC patients but not among HBV or HCV patients. These genotypes might affect HCC prognosis in ALD patients, but not in HBV, HCV, or NAFLD patients.No potential conflict of interest relevant to this article was reported.American Society for MicrobiologyActa Medica Okayama0095-11375222014Necessity for Reassessment of Patients with Serogroup 2 Hepatitis C Virus (HCV) and Undetectable Serum HCV RNA544548ENYukiMoritouFusaoIkedaYasutoTakeuchiHiroyukiSekiShintaroNanbaYoshiakiIwasakiKazuhideYamamotoWe encountered a patient positive for anti-hepatitis C virus (HCV) whose serum HCV RNA was undetectable with the Roche AmpliPrep/Cobas TaqMan HCV assay (CAP/CTM) version 1 but showed a high viral load with the Abbott RealTime HCV assay (ART). Discrepancies in the detectability of serum HCV RNA were investigated among 891 consecutive patients who were positive for anti-HCV. Specific nucleotide variations causing the undetectability of HCV RNA were determined and confirmed by synthesizing RNA coding those variations. Serum samples with the discrepancies were also reassessed by CAP/CTM version 2. Among the 891 anti-HCV-positive patients, 4 patients had serum HCV RNA levels that were undetectable by CAP/CTM version 1 despite having levels of > 5 log IU/ml that were detected by ART. All four patients had HCV genotype 2a and high titers of anti-HCV. Sequencing of the HCV 5' noncoding regions revealed 2 common variations, A at nucleotide (nt) 145 and T at nt 151. Synthesized RNAs of the HCV 5' noncoding region with standard (NCR145G151C) and variant nucleotides at nt 145 and nt 151 were quantified with CAP/CTM. RNAs of NCR145G151C and NCR145G151T were quantifiable with CAP/CTM version 1, while those of NCR145A151T and NCR145A151C went undetected. The substitution from G to A at nt 145 specifically conferred this undetectability, while this undetectability was reverted in synthesized HCV RNA with correction of this variation. Reassessment of these samples by CAP/CTM version 2 resulted in similar levels of HCV RNA being detected by ART. We conclude that HCV patients with undetectable HCV RNA by CAP/CTM version 1 should be reassessed for viral quantification.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231572014備前吉備津宮からみた一宮制(21)(27)ENNatsukiSaitoHikaruTabuchi10.18926/bgeou/52952 備前一宮とされる吉備津宮に関連する「備前国一宮社法」「備前国総社家社僧中神前御祈念之事等注文」「備前一宮御神事絵巻」は、室町時
代の年紀を有し、中世史料と考えられてきた。しかし、人名、地名、および「国主」という用語に即して関連史料を探索してみると、近世初
期に成立した史料と考えられる。それでも史料の作成者が、康永や文明など中世の年号を付したのは、中世松田氏が近世池田氏の前身だとい
う近世初期の歴史認識の現れと考察した。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231572014池田光政公の御涼所の気温について4348ENKenSahashi10.18926/bgeou/52949 ある記録（有斐録）によると，江戸初期の備前藩主池田光政公は，「御涼所」を現在の岡
山市北区中原のあたりに定め，そこで暑さを凌いでいたそうである。
本論は，実際に夏期好晴日に岡山城近くと，中原での気温を測定し，それが二カ所でどの
ように違うか違わないかを調べた結果を示したものである。夏の好晴日だと10 分間程度の
短い間では５℃，一時間程度の長い間の平均値でも２℃程度，御涼所の方が低温であること
があることがわかった。つまり当時でも人が多かったであろう城下町より，大幅に低温であ
っただろうことが推定される。No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812632014Reduced Port Surgeryで切除した高度炎症を伴う虫垂中に発見された潜在性虫垂粘液嚢胞腺腫の１例223226ENHiromitsuSuzukiKoujiKimuraSigekiKinoshitaKazuoOkanoAppendicitis is a benign disease for which surgical treatment is widely provided. The complication of neoplastic lesions may be discovered only after resection. However, in some cases, specimens are not submitted to histopathological examination in Japan because of an extreme deficiency of pathologists. We report our experience with one patient who experienced the complication of latent low-grade appendiceal mucinous neoplasm (LAMN) after surgery for appendicitis.
Our patient was an 85-year-old woman. Conservative treatment failed to relieve fever and lower abdominal pain and it was decided to treat her surgically. Abdominal computed tomography (CT) showed appendicitis with severe inflammation and suspected adhesion. We decided to explore the abdominal cavity using a reduced-port laparoscopic approach. We found no mucous debouchment or clear tumors in the specimen. Histopathological findings indicated the coexistence of appendicitis and LAMN. At one year and a half after surgery, there was no evidence of the development of pseudomyxoma peritonei.
In appendectomy, it is thought that careful perioperative treatment and a postoperative pathological search are important when there are no preoperative findings suggesting a neoplastic lesion.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6852014Hepatitis C Virus-specific T-cell Response Correlates with Hepatitis Activity and Donor IL28B Genotype Early after Liver Transplantation291302ENRyuichiroTsuzakiAkinobuTakakiTakahitoYagiFusaoIkedaKazukoKoikeYoshiakiIwasakiHidenoriShirahaYasuhiroMiyakeHiroshiSadamoriSusumuShinouraYuzoUmedaRyuichiYoshidaDaisukeNobuokaMasashiUtsumiEiichiNakayamaToshiyoshiFujiwaraKazuhideYamamotoOriginal Article10.18926/AMO/52898It is not known how the immune system targets hepatitis C virus (HCV)-infected HLA-mismatched hepatocytes under immune-suppressed conditions after orthotopic liver transplantation (OLT). In addition, the relationship between the HCV-specific immune response and IL28B variants as predictors of HCV clearance has not been well-characterized. We determined the IL28B polymorphisms for 57 post-OLT HCV carriers, and we assessed the HCV-specific immune responses by measuring the peripheral blood mononuclear cell-derived HCV-specific interferon-gamma (IFN-γ) response using an enzyme-linked immunospot assay. At 1-3 years after OLT, patients with no active hepatitis showed higher total spots on the immunospot assay. At＞3 years after OLT, patients with resolved HCV showed higher levels of core, NS3, NS5A, and total spots compared to the chronic hepatitis patients. The IL28B major genotype in the donors correlated with higher spot counts for NS5A and NS5B proteins at 1-3 years after OLT. In the post-OLT setting, the HCV-specific immune response could be strongly induced in patients with no active hepatitis with an IL28B major donor or sustained virological response. Strong immune responses in the patients with no active hepatitis could only be maintained for 3 years and diminished later. It may be beneficial to administer IFN treatment starting 3 years after OLT, to induce the maximum immunological effect.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6852014Nursing Support Increases the Efficacy of Interferon Therapy in Patients with Chronic Hepatitis C263268ENShihokoNambaKayokoMiyakeFusaoIkedaTomokoHazamaYuHitobeNorikoYamasakiHidenoriShirahaAkinobuTakakiKazuhiroNousoYoshiakiIwasakiKazuhideYamamotoOriginal Article10.18926/AMO/52894Nursing support might help patients with chronic hepatitis C (CHC) remain in good mental and physical condition during interferon (IFN) therapy. However, the effects of nursing support have not been studied adequately in this context. This case-control study evaluated the effects of nursing support during IFN therapy. Twenty-four CHC patients who received pegylated IFN and ribavirin were enrolled. Nurses advised patients on the maintenance of their mental and physical condition at weekly visits, based on the results of written questionnaires. An additional 24 patients who received IFN therapy without nursing support and who were matched for age, sex, platelet count, viral serogroup and IFN regimen were selected with propensity score matching as controls. The patients with nursing support during IFN therapy achieved higher sustained virological responses (79%) than those without nursing support (58%). Adherence to the IFN and ribavirin regimens at 24 weeks of therapy were slightly higher in the patients with nursing support than those without it, but these differences were not statistically significant. Adherence to ribavirin after 24 weeks of therapy was significantly higher in those with nursing support than those without it (93% and 66%, p＝0.045). These results suggested that nursing support services could contribute to the virological responses of CHC patients by promoting drug-regimen adherence.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0815-93192922014Assessment of health-related quality of life and how it predicts the outcome of pegylated interferon and ribavirin therapy for chronic hepatitis C337343ENHiroshiMatsushitaFusaoIkedaYoshiakiIwasakiHiroyukiSekiShintaroNanbaYasutoTakeuchiYukiMoritouTetsuyaYasunakaHidekiOnishiYasuhiroMiyakeAkinobuTakakiKazuhiroNousoKazuhideYamamotoBackground and Aim: Chronic infection with hepatitis C virus (HCV) decreases health-related quality of life (HRQOL). The present study was planned to investigate the impact of HRQOL of patients with chronic hepatitis C (CHC) on the outcomes of therapy with pegylated interferon and ribavirin (RBV), in addition to IL28B polymorphisms.
Methods: The present study enrolled 228 CHC patients and assessed their HRQOLs prospectively with the 36-item short-form health survey.
Results: The patients with CHC have lower physical HRQOL status than the general population (P = 0.037, the Z-test). The patients with advanced liver diseases exhibited further decreases in HRQOL (P = 0.036, Spearman's rank correlation coefficient). The score of total HRQOL was significantly lower in the group with sustained virological response (SVR) to the therapy with pegylated interferon and RBV than the non-SVR group (P = 0.031, the Mann-Whitney U-test), with significantly lower scores of mental component and its comprising subscales in the SVR group. Stepwise multivariate logistic regression analysis showed that low HRQOL score <= 400 points was significantly associated with SVR (odds ratio = 2.4, P = 0.013), independently from high platelet counts, low HCV RNA, favorable single-nucleotide polymorphism type of IL28B, and HCV serotype 2. The patients with low HRQOL score will have significantly less decrease in HRQOL score by 4 weeks of the treatment than those with high HRQOL score at baseline (P = 0.0045).
Conclusion: HRQOL is one of the significant predictor of the outcomes of therapy with pegylated interferon and RBV independently from IL28B polymorphism.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0012-28238622012Serum Levels of Soluble Adhesion Molecules as Prognostic Factors for Acute Liver Failure122128ENAtsuyukiOhnishiYasuhiroMiyakeHiroshiMatsushitaKazuyukiMatsumotoAkinobuTakakiTetsuyaYasunakaKazukoKoikeFusaoIkedaHidenoriShirahaKazuhiroNousoKazuhideYamamotoBackground/Aims: In patients with septic shock, the degree of liver dysfunction is correlated with serum levels of soluble intercellular adhesion molecule (sICAM)-1. We aimed to assess the usefulness of serum levels of soluble adhesion molecules as prognostic factors for acute liver failure (ALF). Methods: Serum levels of soluble platelet endothelial cell adhesion molecule (sPECAM)-1, sICAM-3, soluble endothelial (sE) selectin, sICAM-1, soluble platelet selectin, and soluble vascular cell adhesion molecule-1 on admission were measured in 37 ALF patients and 34 healthy controls. Results: Twenty-two ALF patients (59%) reached to fatal outcomes. Serum levels of sPECAM-1, sICAM-3, sE-selectin and sICAM-1 were higher in ALF patients than healthy controls. In 37 ALF patients, by the multivariate logistic regression analysis, ratio of direct to total bilirubin (per 0.1 increase; OR 0.11, 95% CI 0.01-0.99), serum sPECAM-1 level (per 100 ng/ml increase; OR 4.37, 95% CI 1.23-15.5) and serum sICAM-1 level (per 100 ng/ml increase; OR 0.49, 95% CI 0.27-0.89) were associated with fatal outcomes. Using receiver operating characteristics curve, each area under the curve of serum sPECAM-1 and sICMA-1 levels as prognostic factors was 0.71 and 0.74, respectively. Conclusion: Serum sPECAM-1 and sICAM-1 levels may be useful for predicting the prognosis of ALF.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6842014Prevalence and Outcomes of Acute Hepatitis B in Okayama, Japan, 2006-2010243247ENNozomuWadaTetsuyaYasunakaFusaoIkedaSohjiNishinaMasaakiKorenagaKeisukeHinoShin-ichiFujiokaToshiyaOsawaTatsuyaItoshimaMiwaKawanakaGotaroYamadaKazuyaKariyamaHirokiTakayamaJunichiKubotaYoichiMorimotoTakaakiMizushimaHaruhikoYamashitaHiroakiTaniokaYujiNegoroJunichiToshimoriHaruhikoKobashiAtsushiHiranoYasuoItanoAkinobuTakakiKazuhideYamamotoOriginal Article10.18926/AMO/52790Hepatitis B virus (HBV) is one of the major viruses causing acute hepatitis. Recently, the incidence of acute hepatitis with genotype A has been increasing in Japan. The aim of this study was to investigate acute hepatitis B (AHB) in Okayama prefecture, with special attention to HBV genotype A. AHB patients who visited one of 12 general hospitals in Okayama prefecture between 2006 and 2010 were retrospectively analyzed. Over the course of the study period, 128 patients were diagnosed with AHB. Sexual transmission was supposed in the majority of patients (78 patients, 61%), including 59 (76%) having sex with heterosexual partners. The genotypes of HBV were assessed in 90 patients (70%), of whom 27 patients were infected with genotype A, 5 with genotype B, and 58 with genotype C. The prevalence of genotype A was significantly higher among male patients (28.7%), aged 20-29 (35.6%,
p＜0.01), among men who had sex with men (100%, p＜0.005), and among patients having sex with unspecified partners (44.8%, p＜0.005). Genotype A was not a significant factor associated with delayed HBsAg disappearance. Caution should be exercised with regard to sexually transmissible diseases in order to slow the pandemic spread of AHB due to genotype A.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231562014発達障害をともなう子どもへのRey-Osterrieth 複雑図形検査の臨床応用713ENSatoshiSanadaAoiIkedaMidoryHiga DiezYokoKadoTatsuyaOginoKousukeNakanoDaikiYamaneRieYokouchiShinNouno10.18926/bgeou/52775 本研究では，10 名の読みや書きなどの学習面に困難を抱える発達障害をともなう子ども
にWechsler式知能検査およびRey-Osterrieth複雑図形検査（ROCF）を実施し，認知特性の
実態把握の過程におけるROCFの有用性を検討した。ROCFの記録には被検者の描画過程
をデータ化してパソコンに取り込むことのできるタッチペン （Inkling™） を用い，成績評価
には，描画の質的評価も含むBoston Qualitative Scoring System （BQSS） を用いた。
Wechsler式知能検査における知覚統合や知覚推理の下位検査の得点が良好であっても，
ROCFにおいて構成力や描画過程に困難が少なからず認められ，これらは学習面における困
難の背景にある病態を反映したものと考えられた。また，本検査成績を検討する上で，
BQSSの概要得点の1 つである組織構成，概要得点に含まれていないクラスター要素や細部
要素の配置の評価の重要性についても論じた。No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0815-93192612011Serum levels of platelet-derived growth factor-BB and vascular endothelial growth factor as prognostic factors for patients with fulminant hepatic failure116121ENHirokiTakayamaYasuhiroMiyakeKazuhiroNousoFusaoIkedaHidenoriShirahaAkinobuTakakiHaruhikoKobashiKazuhideYamamotoBackground and Aims:
In animal models for acute liver injury, the administration of some angiogenic factors such as vascular endothelial growth factor (VEGF) and granulocyte-colony stimulating factor (G-CSF) are shown to reduce liver injury and improve liver proliferative capacity. The aim of the present study was to assess the role of angiogenic factors in fulminant hepatic failure (FHF).
Methods:
Serum levels of nine angiogenic factors (angiopoietin-2, follistatin, G-CSF, hepatocyte growth factor [HGF], interleukin-8, leptin, platelet-derived growth factor [PDGF]-BB, platelet endothelial cell adhesion molecule-1 and VEGF) were measured using the Bio-Plex Protein Array System in 30 patients, 17 of whom were diagnosed with FHF, 13 with acute hepatitis (AH), and 20 controls.
Results:
Serum levels of PDGF-BB and VEGF were lower in FHF patients than AH patients and controls (PDGF-BB; 2050 +/- 1572 pg/mL vs 4521 +/- 2419 pg/mL vs 8506 +/- 5500 pg/mL, VEGF; 39 +/- 38 pg/mL vs 144 +/- 122 pg/mL vs 205 +/- 121 pg/mL). By using univariate logistic regression models, serum levels of PDGF-BB and VEGF were associated with poor outcomes. Serum PDGF-BB levels were strongly correlated with serum VEGF levels (r = 0.70). Furthermore, serum PDGF-BB levels were significantly correlated with platelet counts (r = 0.79), PT activity (r = 0.37) and D.Bil/T.Bil ratio (r = 0.50), while serum VEGF levels were significantly correlated with platelet counts (r = 0.68) and PT activity (r = 0.38).
Conclusions:
We consider that serum levels of PDGF-BB and VEGF are worth investigating as biomarkers for predicting outcomes of FHF patients.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812622014薬物相互作用 (30―慢性疼痛治療薬の相互作用）159163ENAtsushiOgawaYoshihisaKitamuraToshiakiSendoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812622014直腸腫瘍を契機に発見された無症状の成人右側Bochdalek孔ヘルニアの１例137141ENHiroshiKatoMasahiroOishiMasahitoKoderaMasaoYamamuraHideakiIkedaKenjiMizunoYutakaYamashitaKazunoriSuzuki We encountered a patient with an adult Bochdalek hernia discovered asymptomatically. A 77-year-old Japanese woman visited a local clinic with chief complaints of melena and difficulty in defecation. Based on the results of the detailed examination in our hospital, she was diagnosed with a rectal gastrointestinal stromal tumor (GIST) with a concurrent asymptomatic adult right-sided Bochdalek hernia. Because the tumor was large, laparoscopic abdominoperineal rectal amputation was performed after systemic imatinib therapy. During the surgery, we found a right diaphragmatic defect more than 13cm in long dia., through which the right hepatic lobe, colon, and greater omentum had prolapsed into the right thoracic cavity. No visceral adhesions were noted. No hernia sac was observed. Adult Bochdalek hernia is a relatively rare condition, and only three (incidentally discovered) cases of asymptomatic Bochdalek hernia, including the present case, have been reported in Japan. Here we provide a case report for the patient, who was followed-up without hernia surgery, plus a review of the literature.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812622014性同一性障害に対する包括的治療109115ENYuzaburoNambaNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2014水中探査用マンタロボットの推進制御に関する研究ENMasaakiIkedaNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2013Effect of a Cysteinyl Leukotriene Receptor Antagonist on Experimental Emphysema and Asthma Combined with EmphysemaENGenyoIkedaNo potential conflict of interest relevant to this article was reported.岡山大学理学部地球科学教室Acta Medica Okayama1340-741420120132004年10月後半の台風23号に伴う日本列島での広域の降水（台風18号と比較して）1324ENAiSatakeKuranoshinKatoYoshinoriMoriYasuhiroGodaShoichiroIkedaOsamuTsukamoto10.18926/ESR/52166Rainfall distribution in the Japan Islands associated with the approach of Typhoon No.23 around 20 October
2004 (referred to Ty0423, hereafter) showed considerably different features from those in late summer of this
year. The present study examined the detailed rainfall features around the Japan Islands brought by Ty0423
and the atmospheric processes based on the operational observation data by the Japan Meteorological Agency
(JMA), comparing with those in association with Ty0418 around 7 September 2004.
During the stage when Ty0423 was approaching or landing on the western part of the Japan Islands, the
areal mean precipitation from Kyushu to Kanto District attained much larger than that for Ty0418, with wider
extension of the area with the large amount of precipitation. It is interesting that, although the intense rainfall
was observed only at the upstream side of the mountain range from Kyushu to Honshu District for Ty0418
except for the area near its center, strong rainfall with 10~30 mm/h persisted in wider regions from the western
to the eastern part of the Japan Islands, resulting in the considerably large total rainfall for Ty0423.
As for the case for Ty0423, the surface front with stable frontal surface was located just to the east of the
Ty0423 center just before its landing at the Japan Islands. Thus, the huge moisture inflow mainly in the eastern
region from the typhoon center seems to be redistributed widely over the Japan Islands area associated with
the large-scale convergence around the stable frontal surface. In late October, the colder air associated with
the high pressure system in the eastern Siberia can cover the northern part of the Japan Sea area as the seasonal
march. Such basic field might be favorable for sustaining the synoptic-scale front just around the southern
coast of the Japan Islands, even when the strong southerly wind invades associated with the typhoon approach
there.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6812014Impact of Comorbid Hepatic Steatosis on Treatment of Chronic Hepatitis C in Japanese Patients and the Relationship with Genetic Polymorphism of IL28B, PNPLA3 and LDL Receptor1722ENYukiMoritouFusaoIkedaYoshiakiIwasakiNobuyukiBabaKouichiTakaguchiTomonoriSenohTakuyaNaganoYasutoTakeuchiTetsuyaYasunakaHidekiOhnishiYasuhiroMiyakeAkinobuTakakiKazuhiroNousoKazuhideYamamotoOriginal Article10.18926/AMO/52139The impact of hepatic steatosis on interferon therapy for patients with chronic hepatitis C (CHC) has been associated with single-nucleotide polymorphisms (SNP) of IL28B, patatin-like phospholipase domain-containing protein 3 (PNPLA3), and low-density lipoprotein (LDL) receptor. Whether this holds true for Japanese patients, however, remains unresolved. The present study prospectively enrolled 226 Japanese patients with CHC, and investigated the impact of hepatic steatosis and its related SNPs, including rs8099917 of IL28B, rs738409 of PNPLA3, and rs14158 of LDL receptor, on outcomes of peg-interferon and ribavirin therapy. In multivariate logistic regression analysis, significant factors affecting the severity of hepatic steatosis were high body mass index and the minor alleles of IL28B SNP (p＝0.020 and 0.039, respectively). The risk alleles of PNPLA3 SNP also showed weak association
(p＝0.059). Severe steatosis and the minor alleles of IL28B SNP were significantly associated with null or partial virological response in patients with HCV genotype 1, as were female gender, and low LDL cholesterol (p＝0.049, and ＜0.001, respectively). The SNP genotype of PNPLA3 and LDL receptor
did not have a significant impact on therapeutic outcomes. With respect to the SNP sites examined, the SNP of PNPLA3 has a weak association with severe hepatic steatosis, but not with the outcome of interferon therapy.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0944-11744742012Risk factors for recurrence after transarterial chemoembolization for early-stage hepatocellular carcinoma421426ENHideakiKinugasaKazuhiroNousoYasutoTakeuchiTetsuyaYasunakaHidekiOnishiShin-ichiroNakamuraHidenoriShirahaKenjiKuwakiHiroakiHagiharaFusaoIkedaYasuhiroMiyakeAkinobuTakakiKazuhideYamamotoRadiofrequency ablation (RFA) is a standard therapy for the treatment of hepatocellular carcinoma (HCC) with 3 or fewer tumors of up to 3 cm (early-stage HCC); when RFA is unsuccessful or unfeasible, transcatheter arterial chemoembolization (TACE) has often been performed. However, little information about the outcome of TACE for early-stage HCC has been reported and it is hard to decide whether to perform additional treatment following TACE in these difficult conditions. The aim of this study was to determine the risk factors for local or intrahepatic distant recurrence after TACE in early-stage HCC.
Among 1,560 newly diagnosed HCC patients who were admitted to Okayama University Hospital, 43 patients with early-stage HCC who received only TACE in at least one nodule were enrolled in this study. We analyzed the risk factors for local and distant recurrence by the Cox proportional hazard model.
The local recurrence rates and intrahepatic distant recurrence rates at 3 months, 6 months, and 1 year were 18.6, 33.4, and 61.8%, and 2.8, 2.8, and 10.2%, respectively. Among 12 parameters examined as possible risk factors for recurrence, heterogeneous Lipiodol uptake (risk ratio 3.38; 95% confidence interval 1.14-10.60) and high serum des-gamma-carboxy prothrombin (DCP) (2.58; 1.03-7.14) were significantly correlated with local recurrence, and the presence of multiple tumors (10.64; 1.76-93.75) was significantly correlated with intrahepatic distant recurrence.
Heterogeneous Lipiodol uptake, high serum DCP, and multiple tumors are risk factors for recurrence in patients with early-stage HCC who have undergone palliative TACE.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama0944-11744492009Mortality rate of patients with asymptomatic primary biliary cirrhosis diagnosed at age 55 years or older is similar to that of the general population10001006ENJunichiKubotaFusaoIkedaRyoTeradaHaruhikoKobashiShin-ichiFujiokaRyoichiOkamotoShinsukeBabaYouichiMorimotoMasaharuAndoYasuhiroMakinoHideakiTaniguchiTetsuyaYasunakaYasuhiroMiyakeYoshiakiIwasakiKazuhideYamamotoRecent routine testing for liver function and anti-mitochondrial antibodies has increased the number of newly diagnosed patients with primary biliary cirrhosis (PBC). This study investigated the prognosis of asymptomatic PBC patients, focusing on age difference, to clarify its effect on the prognosis of PBC patients.
The study was a systematic cohort analysis of 308 consecutive patients diagnosed with asymptomatic PBC. We compared prognosis between the elderly (55 years or older at the time of diagnosis) and the young patients (< 55 years). The mortality rate of the patients was also compared with that of an age- and gender-matched general population.
The elderly patients showed a higher aspartate aminotransferase-to-platelet ratio, and lower alanine aminotransferase level than the young patients (P < 0.01 and P = 0.03, respectively). The two groups showed similar values for alkaline phosphatase and immunoglobulin M. Death in the young patients was more likely to be due to liver failure (71%), while the elderly were likely to die from other causes before the occurrence of liver failure (88%; P < 0.01), especially from malignancies (35%). The mortality rate of the elderly patients was not different from that of the age- and gender-matched general population (standardized mortality ratio, 1.1; 95% confidence interval, 0.6-1.7), although this rate was significantly higher than that of the young patients (P = 0.044).
PBC often presents as more advanced disease in elderly patients than in the young. However, the mortality rate of the elderly patients is not different from that of an age- and gender-matched general population.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812532013細菌性髄膜炎の治療ガイドライン257258ENYoshioIkedaKojiAbeNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812532013Th２サイトカインはアトピー性皮膚炎患者における カリクレイン７の発現と機能を増強する217220ENShinMorizaneKenshiYamasakiAiKajitaKazukoIkedaMaoshengZhanYumiAoyamaRichard L GalloKeijiIwatsukiNo potential conflict of interest relevant to this article was reported.Wiley-BlackwellActa Medica Okayama1386-634643102013Serum oxidative-anti-oxidative stress balance is dysregulated in patients with hepatitis C virus-related hepatocellular carcinoma10781092ENMamoruNishimuraAkinobuTakakiNaofumiTamakiTakayukiMaruyamaHidekiOnishiSayoKobayashiKazuhiroNousoTetsuyaYasunakaKazukoKoikeHiroakiHagiharaKenjiKuwakiShinichiroNakamuraFusaoIkedaYoshiakiIwasakiTakaakiTomofujiManabuMoritaKazuhideYamamotoAim
Oxidative stress is associated with progression of chronic liver disease (CLD). This association is best established in chronic hepatitis C. However, the anti-oxidative state is not well characterized. The objective of the present study was to investigate the balance of oxidative and anti-oxidative stress in CLD patients.
Methods
We recruited a study population of 208 patients, including healthy volunteers (HV; n = 15), patients with hepatitis B virus (HBV)-related CLD without or with hepatocellular carcinoma (HBV-non-HCC, n = 25, and HBV-HCC, n = 50, respectively), and patients with hepatitis C virus (HCV)-related CLD without or with HCC (HCV-non-HCC, n = 49, and HCV-HCC, n = 69, respectively). Serum levels of reactive oxygen metabolites (ROM) and anti-oxidative markers (OXY-adsorbent test; OXY) were determined, and the balance of these values was used as the oxidative index. Correlations among ROM, OXY, oxidative index and clinical characteristics were investigated.
Results
Patients with CLD exhibited elevated ROM and oxidative index compared to HV. Among patients with CLD, HCV positive status correlated with increased ROM. In CLD, HCV-HCC patients exhibited the highest ROM levels. Among HCV-related CLD patients, lower OXY correlated with HCC positive status, but was recovered by eradication of HCC. In HCV-HCC, lower OXY correlated with high PT-INR.
Conclusion
HCV positive CLD patients displayed higher oxidative stress and HCV-HCC patients displayed lower anti-oxidative state. Anti-oxidative state depression was associated with liver reservoir-related data in HCV-HCC and could be reversed with HCC eradication.No potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-31551320062006中学校数学｢数量関係｣の学力診断調査の結果と概要3341ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-31551320062006 中学校数学「数量関係」の学力診断調査2732ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812522013敗血症ガイドライン153157ENHiroyukiNishieNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2013マウスのCD49f陽性顎下腺細胞を用いた唾液腺再生に関与する因子の探求ENAtsushiIkedaNo potential conflict of interest relevant to this article was reported.Wiley-BlackwellActa Medica Okayama1386-634642122012Clinical utility of serum fucosylated hemopexin in Japanese patients with hepatocellular carcinoma11871195ENSayoKobayashiKazuhiroNousoHideakiKinugasaYasutoTakeuchiTakeshiTomodaKojiMiyaharaHiroakiHagiharaKenjiKuwakiHidekiOnishiShinichiroNakamuraFusaoIkedaYasuhiroMiyakeHidenoriShirahaAkinobuTakakiKazuhideYamamotoAim: Hepatocellular carcinoma (HCC) is a common clinical problem all over the world. Fucosylated hemopexin (Fuc-Hpx) is a newly reported glycoprotein for the diagnosis of HCC, however, its clinical implications are unclear. The aim of this study was to elucidate the clinical utility of Fuc-Hpx in Japanese patients with HCC.
Methods: The sera from 331 HCC patients, 45 with liver cirrhosis (LC), 85 with chronic hepatitis (CH) and 22 healthy people were examined for the expression of Fuc-Hpx; the level was compared with clinical parameters as well as hemopexin (Hpx) expression. The expressions of Fuc-Hpx in 12 HCC tissues and corresponding adjacent non-cancerous liver tissues were also examined.
Results: No correlation was observed between Hpx and Fuc-Hpx level. The median Fuc-Hpx levels in healthy people and CH, LC and HCC patients were 3.8, 3.7, 6.1 and 7.6 AU/mL, respectively (CH vs LC, P = 0.002; CH vs HCC, P < 0.001; LC vs HCC, P = 0.02). Multivariate analysis revealed that low albumin, low prothrombin time and the presence of HCC were significantly correlated with high Fuc-Hpx (P = 0.013, =0.001 and <0.001, respectively). Among the HCC patients, albumin was correlated with high Fuc-Hpx; however, none of the tumor factors, such as tumor size, tumor number and tumor stage, was correlated with Fuc-Hpx level. The expression of Fuc-Hpx in cancer tissue was not different from that in non-cancerous tissue.
Conclusion: Fuc-Hpx is a valuable biomarker for HCC but it might be a marker for hypercarcinogenic liver rather than a marker for tumor-bearing liver.No potential conflict of interest relevant to this article was reported.Academic Press Inc Elsevier ScienceActa Medica Okayama0006-291X43022013PML tumor suppressor protein is required for HCV production592597ENMisaoKurokiYasuoAriumiMakotoHijikataMasanoriIkedaHiromichiDansakoTakajiWakitaKunitadaShimotohnoNobuyukiKatoPML tumor suppressor protein, which forms discrete nuclear structures termed PML-nuclear bodies, has been associated with several cellular functions, including cell proliferation, apoptosis and antiviral defense. Recently, it was reported that the HCV core protein colocalizes with PML in PML-NBs and abrogates the PML function through interaction with PML. However, role(s) of PML in HCV life cycle is unknown. To test whether or not PML affects HCV life cycle, we examined the level of secreted HCV core and the infectivity of HCV in the culture supernatants as well as the level of HCV RNA in HuH-7-derived RSc cells, in which HCV-JFH1 can infect and efficiently replicate, stably expressing short hairpin RNA targeted to PML. In this context, the level of secreted HCV core and the infectivity in the supernatants from PML knockdown cells was remarkably reduced, whereas the level of HCV RNA in the PML knockdown cells was not significantly affected in spite of very effective knockdown of PML. In fact, we showed that PML is unrelated to HCV RNA replication using the subgenomic HCV-JFH1 replicon RNA, JRN/3-5B. Furthermore, the infectivity of HCV-like particle in the culture supernatants was significantly reduced in PML knockdown JRN/3-5B cells expressing core to NS2 coding region of HCV-JFH1 genome using the trans-packaging system. Finally, we also demonstrated that INI1 and DDX5, the PML-related proteins, are involved in HCV production. Taken together, these findings suggest that PML is required for HCV production.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama1554-8627682010In vivo imaging of autophagy in a mouse stroke model11071114ENFengFengTianKentaroDeguchiToruYamashitaYasuyukiOhtaNobutoshiMorimotoJingweiShangXuemeiZhangNingLiuYoshioIkedaTohruMatsuuraKojiAbeRecent studies have suggested that autophagy is involved in a neural death pathway following cerebral ischemia. In vivo detection of autophagy could be important for evaluating ischemic neural cell damage for human stroke patients. Using novel green fluorescent protein (GFP)-fused microtubule-associated protein 1 light chain 3 (LC3) transgenic (Tg) mice, in vivo imaging of autophagy was performed at 1, 3 and 6 d after 60 min transient middle cerebral artery occlusion (tMCAO). Ex vivo imaging of autophagy, testing of the autophagy inhibitor 3-methyladenine (3-MA), estern blot analysis, immunohistochemistry, terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) and fluorescent analyses were performed on brain sections following tMCAO. In vivo fluorescent signals were detected above the ischemic hemisphere through the skull bone at 1, 3 and 6 d after tMCAO, with a peak at 1 d. Similar results were obtained with ex vivo fluorescence imaging. western blot analysis revealed maximum LC3-I and LC3-II expression at 1 d after tMCAO and fluorescence immunohistochemistry demonstrated that GFP-LC3-positive cells were primarily neuronal, not astroglial or microglial, cells. The number of GFP-LC3/TUNEL double-positive cells was greater in the peri-ischemic area than in the core. These results provided evidence of in vivo autophagy detection, with a peak at 1 d, in a live animal model following cerebral ischemia. This novel technique could be valuable for monitoring autophagic processes in vivo in live stroke patients, as well as for clarifying the detailed role of autophagy in the ischemic brain, as well as in other neurological diseases.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812512013内陸地津山で発症した季節外れのVibrio vulnificus感染症3539ENHideharuHagiyaSumikoShiotaShin-ichiMiyoshiYasutoshiKuroeHiroyoshiNojimaShinkichiOtaniJunichiSugiyamaHiromichiNaitoSusumuKawanishiShingoHagiokaNaokiMorimoto A 68-year-old man with alcohol addiction, who lived in the suburbs of Tsuyama, an inland city located in northeast Okayama prefecture, was transported to the emergency unit of the Tsuyama Central Hospital in a state of cardiopulmonary arrest (CPA). Despite rigorous systemic investigation and treatment, the patient died 2 hours after arrival. After his death, Vibrio vulnificus was isolated from his blood culture.
Vibrio vulnificus causes fatal infection in humans, usually only in areas located close to the sea where appropriate temperature and suitable salt concentration for its growth are available. Therefore, its occurrence is epidemiologically restricted ; in Japan, the western coastal areas, especially in summers, are reported to be the high-risk regions. This is a rare case because it occurred in a city approximately 50 kilometers from both the Sea of Japan and the Pacific coast of Okayama, and at the end of October in 2011. Economic development and distribution systems have made it possible to transport various food products from coastal areas or abroad to any place in a short time, such that these infections can potentially develop in areas other than expected. We should be aware of the increasing risk of Vibrio vulnificus infection during any season and at any place, especially in patients with abnormal liver function.No potential conflict of interest relevant to this article was reported.岡山大学埋蔵文化財調査研究センターActa Medica Okayama272011津島岡大道跡 20 ―第32次調査― （教育学部剣道場新営工事に伴う発掘調査）ENNo potential conflict of interest relevant to this article was reported.岡山大学埋蔵文化財調査研究センターActa Medica Okayama20092011岡山大学埋蔵文化財調査研究センター紀要2009ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812412012膵炎を伴った胃異所性膵の1切除例5962ENSusumuShinouraTakahitoYagiHiroshiSadamoriHiroakiMatsudaYuzoUmedaRyuichiYoshidaDaisukeSatohMasashiUtsumiNaosukeYokomichiTakashiKuiseToshiyoshiFujiwaraWe experienced a case of gastric aberrant pancreas with acute pancreatitis. The patient was a 42-year-old man. He was referred to our hospital because of epigastric pain. A CT scan and endoscopic examination revealed a gastric submucosal tumor with inflammation. His serum amylase level was high at 222 IU/l. Endoscopic ultrasonography revealed a hypoechoic mass lesion, 3 cm in diameter, at the body of his stomach. Endoscopic ultrasoundscopy-guided fine needle aspiration was performed. Pathological examination showed pancreatic tissue. So, he underwent partial gastrectomy due to gastric aberrant pancreas with pancreatitis. There are very few cases of gastric aberrant pancreas with pancreatitis on record.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558303381918天然營養兒ニ襲來スル一種特有ノ神經症状ヲ具備スル所ノ一新疾患ニ就テ269295ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558323711920所謂人乳中毒症及ビ乳兒脚氣ノ異同問題ニ就テ646666EN(一)所謂人乳中毒症ニ於ケル精紳症状ハ、輕症ナルモノニ於テハ、一過性ノ興奮性充進竝ニ嗜眠状態ヲ呈スルニ過ギザルモ、重症ナルモノニ於テハ、更ニ進ミテ意識溷濁乃至無慾状顔貌ヲ呈シ、周圍ノ事情ニ對スル識別力ヲ失ヒ笑ハズ泣カズ、眼付曇ヨリシ、時トシテ舞踏病樣不隨意運動乃至不明ノ言ラ發ス、カク特異ナル精紳症状ヲ呈スルハ神經申樞ニ何等カノ病變ノ存スルモノト考ヘザルベカラズ、余ハカカル患者ニ遭遇スル毎ニ勉メテ腰椎穿刺ヲ行ヒ腦脊髓液ノ性状ヲ檢シタルニ、ソノ外觀、比重、糖反應、蛋白量、蜘蛛網状物形成ノ有無等ノ關係ハ、多クハ健康者ノモノト差異ヲ認ムルコト能ハザリシモ、「グロブリン」反應及ビ細胞數ニ於テ輕微ノ變化ノ存スルヲ認メタリ、即チ「グロブリン」反應中、ノンネーアツペルト氏反應竝ニパンヂー氏反應ハ多クハ陰性(時トシテ弱陽性ナルコトアリ)ナルモ野口氏反應ハ毎常弱陽性ヲ示セリ、而シテ淋巴球ノ數ハ通常ナルカ或ハ僅ニ増加セリ、即チ輕度ノ漿液性腦膜炎ノ腦脊髓液ニ相類似ス、カカル腦脊髓液ノ變化ハ唐澤博士ノ報告セル軟腦膜ニ於ケル解剖的變化ト相符合ス。(二)臨牀上ニ於ケル所謂人乳中毒症ト乳兒脚氣トノ主要ナル區別點ハ、伊東博士ニ依レバ血行器症状竝ニ精神症状ノ有無ニ存ス、然レドモ血行器症状ハ兩疾患ヲ鑑別スルニ向ツテ爾カク重要ナル資料トナスヲ得ズ、蓋シ血行器症状ハ乳兒脚氣ニ於ケル必要ナル症状ノ一ツナルモ而モ之ヲ伴ハザルモノ稀ナラズ、又所謂人乳中毒症ニ於テモ血行器症状ハ必ラズ缺如スベキモノニアラザルガ故ナリ、況ンヤ症例(三)ニ於ケルガ如ク、所謂人乳中毒症ニ於テ其ノ經渦中ニ突然衝心症状ヲ表ハシタル事實アルエ於テオヤ。精神症状ノ有無ニ至リテハ、吾人ハ兩疾患ニ於ケル最モ顯著ナル差異タルヲ是認セザルベカラズ、然レドモ大人脚氣ニ於テ稀ニ精神症状ヲ伴フコトアルコト竝ニ余ノ實驗例ノ如ク幼兒脚氣ニ於テ躁暴狂状乃至昏迷ヲ呈シ、而モ軟腦膜ノ病理解剖的所見ニ於テ所謂人乳中毒症ト殆ド同樣ナル病變ヲ呈セルコトアル事實ヨリ推考スル時ハ、乳兒脚氣ニアリテモ亦精神症状ノ表ハルルコトアリテ可ナル理ナリ。(三)所謂人乳中毒症ト母體脚氣トハ甚ダ密接ナル關係ヲ有スルハ余ノ統計的觀察ニ依リテ明カナリ、余ノ症例(四)及ピ(五)ハ正シクコノ事實ヲ立證セルモスト云フヲ得ベシ、即チ余ノ症例ハ哺乳ノ時期ヲ異ニスルモ、脚氣ヲ有スル同一母體ノ乳汁ヲ哺乳シタルニ依リテ、第四子ハ乳兒脚氣ヲ惹起シ、第五子ハ所謂人乳中毒症ヲ惹起セルモノトス、カカル事實ハ、所謂人乳中毒症ハ其ノ本態ニ於テ乳兒脚氣症ト同一ナルモノニアラズヤトノ疑念ヲ益々吾人ニ抱カシム。(四)以上ノ事實ヲ綜合スル時ハ、所謂人乳中毒症ハ其ノ本態ニ於テ乳兒脚氣ト同一上ニ立ツベキ疾患ニシテ、詳言セバ乳兒脚氣ノ一異型ト見做スベキモノナリト信ズ、余思ヘラク、乳兒脚氣ハ脚氣毒素ガ母體ノ乳汁ヲ介シテ小兒ニ移行スルニ依リテ起ル一種ノ中毒症ニ外ナラズ、而シテ臨牀上ニ於テ一方ニハ專ラ心臓機能ヲ障碍スル衝心型アリ又他方ニ血行器症状ヲ件ハズシテ専ラ末梢神經ヲ侵ス所ノ麻痺型ナルモノアリ、コレ等ノ事實ヨリ考フル時ハ脚氣毒素ガ主トシテ心臓ヲ侵ス時ハ衝心型トナリテ表ハレ、主トシテ末梢神經ヲ侵ス時ハ麻痺型トナリテ表ハレ、專ラ腦膜ヲ侵ス時ハ所謂人乳中毒症ノ型トナリテ表ハルルモノニアラザルカ、カカル關係ハカノ麻疹ノ例ニ於テ之ヲ見ル、即チ症状ノ劇烈ナルモノニ於テハ、多クハ肺炎ヲ合併シコレト同時ニ心臓衰弱ヲ招來スルモ、時トシテハ主トシテ中樞神經系統ニ障碍ヲ及ボシ、既ニ前驅期或ハ發疹期ノ初メニ於テ意識溷濁ヲ來シ遂ニ無慾状態ニ陷ルコトアリ、又恢復期ニ於テ稀ニ腦膜ヲ侵シ漿液性腦膜炎ヲ惹起スルモノアリ、是レ麻疹毒ハ時ニ主トシテ中樞神經系統ヲ侵スコトアルヲ意味スルモノニシテ、以上述ベタル余ノ乳兒脚氣ニ於ケル説明ト相符合スル點アルヲ以テ茲ニ之ヲ引用シタルニ過ギズ、カク觀察シ來ル時ハ精神症状ノ有無ハ敢テ問題トナスニ足ラザルナリ、余ハ所謂人乳中毒症ヲ乳兒脚氣腦型トナシ乳兒脚氣中ニ包括スルニ賛スル者ナリ。No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558323651920間質性肺炎ニ因スル小兒氣胸ノ一例317321EN本症例ハ瓣状ノ氣胸ニシテ、而モ兩側肋膜腔内ニハ些少ノ滲出液ヲモ容レザル眞ノ氣胸例ナリトス、而シテ本症例ニ於テ氣胸ヲ起シタル原因ヲ尋ヌルニ、本患者ハ臨牀上ビルケー氏反應陰性ニシテ、且病理解剖上何處ニモ結核性病竈ヲ證明セザリシヲ以テ見レバ、結核ニ原因シタルモノニアラザルヲ知ル、而シテ病理解剖上兩肺ニ於ケル肺氣腫、氣管枝擴張、慢性間質性肺炎等ノ存スル點ヨリ見レバ、患兒ハ發病一箇月前ニ毛細氣管枝炎ヲ患ヒ、其ノ際全治ニ至ラズシテ間質性肺炎ヲ續發シ、次デ代償性ニ肺氣腫乃至氣管枝擴張ヲ惹起シ、コレガアル機會ニ肋膜腔内ニ破壞シタルモノト想像スルヲ至當ナリト信ズ。No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558323621920「カプセルバチルス」ニ因スル小兒化膿性膀胱炎ニ就テ91110ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558333751921膽汁酸鹽類ニ關スル研究竝ニ肝臟ノ生理ニ關スル知見補遺287342ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558374281925諸種疾患ニ於ケル脉絡叢ノ病理學的所見（承前）900928ENMasaoIkedaDie histopathologischen Veränderungen des Plexus chorioidei sind nur bei den Geisteskrankheiten einigermassen genauer studiert worden, während sie bei anderen Erkrankungen nur verhälthismässig wenig in der Literatur zu finden sind. Ich habe es deshalb unternommen, die feineren Veränderungen des Plexus chorioideus bei den verschiedensten Krankheiten eingehender zu untersuchen. Die Gesamtzahl der von mir untersuchten Fälle beträgt 188, die sich auf die folgenden 15 Krankheiten verteilen: Meningitiden 49 Fälle (d. h. tuberkulöse Meningitis 26, Encephalitis lethargica und sogenannte Meningitis 6, eitrige 10 und epidemische 7.), Spirochätosis ikterohämorrhagica (Morbus Weili) 18 Fälle, Hirntumor 5 Fälle, Dysenterie 9 Fälle, Typhus abdominalis 8 Fälle, Ekiri (eine der Kinderdysenterie verwandte Erkrankung) 4 Fälle, Lyssa 2 Fälle, Septicopyämie 3 Fälle, chronische myeloide Leukämie 2 Fälle, Pneumonie 7 Fälle, Lungentuberkulose 7 Fälle, Syphilis 5 Fälle und andere. Die Ergebnisse meiner Untersuchungen will ich im nachfolgenden kurz zusammenfassen. Leptomeningitis tuberculosa. Unter 26 Fällen desselben fand ich bei 23 Fällen tuberkulöse Herde in dem Flexus. Dabei spielten tuberkulöse Granulationsentzündungen die Hauptrolle, während die Bildung typischer Tuberkeln mehr in den Hintergrund trat. Typische Tuberkelbildung fand sich nur in 7 Fällen. Bei erstgenannten Fällen waren besonders zahlreiche Infiltrationszellen in den zottenfreien Teilen vorhanden, wenn sie auch in dem Zottenstroma nicht fehlten. Die Zottenstroma sind ödematös locker. Die Plexusepithelien waren meist gequollen und degeneritert, in manchen Fällen sogar desquamiert. In den zellig infiltrierten tuberkulösen Herden waren neben vereinzelten Plasmazellen und gewöhnlichen Lymphocyten auch gewisse Mengen der verschiedenartigen Makrophagen (im Sinne Metschnikoffs) vorhanden. Diese Makrophagen haben einen grossen Zelleib, dessen Gestalt rund, oval oder unregelmässig und dessen Protoplasma oft homogenisiert oder vacuolisiert ist. Die Zellen sind oft zwei- oder mehrkernig. Im Verhälthis zu dem grossen, blasigen Zelleibe ist der Kern retativ klein und häufig in der Peripherie gelegen. Die Form des Kernes ist verschieden, meist einfach rund oft oval. Diese Makrophagen enthalten oft rote Blutkörperchen, Reste von letzteren, ferner mehrere Leucocyten, Plasmazellen oder die in Zerfall begriffenen Zellen unbekannter Herkunft in ihrem Zelleibe. Manchmal enthalten mononukleäre Makrophagen keine körnigen bezw. zelligen Einschlüsse, sondern nur rundliche, etwas transparente Gebilden, die vielleicht durch Verflüssigung früher aufgenommener Zellen entstanden sind. Die Makrophagen finden sich nun nicht nur bei tuberkulöser Meningitis, sondern auch bei anderen Erkrankungen, so z. B. bei eitriger Meningitis, epidemischer Meningitis sowie bei Morbus Weili, Lyssa, Septicepyämie u. s. w. Aber sie zeigen verschiedene Beschaffenheiten je nach den Umständen. So Z. B. bei eiterigen Meningitiden sind ihre Kerne relativ gross und blass und findet sich im Zentrum des Zelleibs. Bei Morbus Welli erscheinen sie als grosse, den plasmazellen ähnliche Zellen, während sie bei Lyssa und Septicopyämie sich als grosse epitheloide Zellen präsentieren. Die Makrophagen zeigen bei tuberkulöser und eitriger Meningitis lebhafte phagozytöse Wirkung, während sie bei Lyssa und Septicopyämie dieselbe nur in geringem Masse ausführen. Bei Morbus Weili zeigten die Zottenstroma in vielen Fällen eine mehr oder weniger auffallende oedematöse Lockerung sowie zellige Infiltratinsherde von sehr verschiedener Stärke und Verteilung. Unter den Infiltrationszellen überwogen kleine und grosse Lymphozyten, denen auch zahlreiche Plasmazellen und Leukozyten beigemischt waren. Daneben waren grösere oder kleinere Blutungen fast stets zu konstatieren. Manchmal traten Blutungen und zellige Infiltration gleichzeitig auf. Soweit ich feststellen konnte, waren die entzündlichen Erscheinungen im Plexus chorioideus urn so hochgradiger, je früher der Tod eintrat, und zwar am hochgradigsten war die Entzüdung in den Fällen, die in 6-9 Tagen nach Krankheitsbeginn mit dem Tode ausgingen. Die Entzündungserscheinungen des Plexus Chorioideus steigern sich in der ersten Krankheitswoche allmählich in die Höhe und erreicht mit den erwähnten 6-9 Tagen in den höchsten Punkt, um dann allmählich wieder nachzulassen. So kann man bei denjenigen Fällen, welche um etwa 20 Krankheitstage gestorben sind, zellige Infiltration oder Blutungen nicht mehr im Plexus finden. In den 7 untersuchten Fallen von Meningitis cerebrospinalis epidemica war der Plexus chorioiclues ebenfalls von Entzündungen ergriffen. Das Zottenstroma ist mit zahlreiehen Eiterzellen, ausserdem aber auch mit mononucleaeren Zellen und Lymphocyten infiltriert. Haufen von abgestossenen Plexusepitbelien und Verkalkung sind häufig in dem Zottenstromi zu beobachten. In 10 Fällen von Meningitis purulenta war ebenfalls ausgedehnte, hochgradige eitrige Infiltration zu beobachten, zu der auch Lymphocyten und Plasmazellen sich mischten, also eine der epidemischen Meningitis ähnliche Veränderuog, jedoch hier in einen stärkerem Grade. Dementsprechend wurden die Blutungen hier in alien Fällen gefunden, während sie bei epidemischer Meningitis nur in 25% der Fälle. Abgestossene Epithelien und Makrophagen waren reichlich zu beobachten, ebenso Oedem des Zottenstromas und Verkalkung. Bei Encephalitis lethargica und sog. Meningitis fand ich stellenweise zellige Infiltrationsherde besonders im zottenfreien Teile. Auch grosse mononucleaere Zellen wurden zuweilen in solchen Herden beobachtet. Bei Lyssa zeigt der Plexus deutlich sichtbare entzündliche Erscheinuogen und Blutungen. Zu den Infiltrationszellen gesellen sich mässig zahlreich grosse, nur selten phagocytierende epitheloide Zellen. Das Oedem im Stroma ist sehr deutlich. Die Plexusepithelien sind aufgequollen, degeneriert und häufig abgestossen. Bei Septicopyämie finden sich ähnliche Veränderungen wie bei Lyssa, und zwar man trifft hier zuweilen auch eitrige Infiltrationen. Bei Typhus abdominalis, Dysenterie, Ekiri, Syphilis (angeborenen und erworbenen) und Pneumonie zeigte der Plexus chorioideus gewisse Veränderungen, die darin bestanden, dass das Bindegewebe sowohl des perivasculären Gewebes als auch des Zottenstromas zellreich wurde, was als das Zeichen von Entzündung anzufassen war. Die infiltrierten Zellen sind teils mononucleäre Zellen teils blasige Epitheloidzellen, teils Rundzellen, zu denen auch spärliche Leucozyten sich gesellten. Ausserdem waren abgestossene Plexusepithelien und wolkige Massen zwischen den Zotten in mässigem Grade vorbanden. Blutungen wurden beobachtet in 60% von Typhus abdominalis, 55% von Dysenterie, 57% von Pneumonia. Die Verkalkung war im Zottenstroma der Syphilisfälle am deutlichsten zu sehen. Bei Lungentuberculose zeigte der Plexus chorioideus keinerlei Veränderungen. In den Hirntumorfällen waren sehr deutliche Lockerung des Bindegewebes stärkere Blutfüllung der Gefasse, Quellung und spärliche Abstossung der Epithelien, sowie Auftreten von Riesenepithelien zu beobachten. Nur in 2 unter 5 Fällen waren ausserdem noch schwache Rundzelleninfiltration und geringe Blutungen zu finden. In den ehronisehen myeloiden Leucämiefällen konnte man ausser leucämischen Infiltrationen im Bindegewebe des Stromas deutliche Blutfullung in allen Gefässen der Zotten und bindegewebigen Grundplatten constatieren. Übrigens war das Stroma sehr locker gefügt und es gaben selten auch Abstossung der Plexusepithelien.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558374271925諸種疾患ニ於ケル脉絡叢ノ病理學的所見789817ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558394471927Beiträge zur Kenntnis der Indophenoloxydasereaktion des Nervensystems446454ENKuranosukeKumagai動物體ノ「オキシダーゼ」反應ニ就イテハEhrlich氏以來多數ノ人々ニ依リ種々ノ方法ヲ以テ檢査セラレタリシガ神經系統ノ「オキシダーゼ」反應ニ關シテハEhrlich氏ハ腦ニ於テAbelous及ビBiarnès氏ハ腦ニ於テVernon氏ハ腦延髓及ビ小腦ニ於テIndopbenolblausyntheseヲ觀察シ只漠然ト其ノ陽性ナルカ陰性ナルカヲ述べ微細ナル點ニハ更ニ言及セズ. 又多クノ學者Slozon, Rosell, Kliopfer,藤原,池田其ノ他ハ神經系統ニハ「オキシダーゼ」ノ存在ヲ否定セリ. 然ルニGäff氏ハ神經組織ニ「オキシダーゼ」反應陽性ナル部分アルコトヲ主張シ殊ニ神經節細胞ニハ非常ニ多數ノ「オキシダーゼ」顆粒アルコトヲ證明セリ.然レドモ其ノ「オキシダーゼ」顆粒ノ微細ナル分布状態ニ關シテハ論及スルトコロナカリキ,勝沼博士ハ1915年v. Gierke氏法ヲ模倣シテ神經系統ノ「オキシダーゼ」反應ヲ精細ニ檢査シテ「オキシダーゼ」顆粒ノ分市状態ヲ詳細ニ記載セラレタリ. 1916年Düring氏ハ病理解屍體ノ新鮮ナル材料ヲ用ヒテ中樞神經節細胞ノ「オキシダーゼ」反應竝ニ其ノ意義ニ就イテ研究セリ. 1922年Kappers氏ハ魚類ノ腦ヲ用ヒテ其ノ神經節細胞ノ「オキシダーゼ」反應ヲ檢査セリ. 予モ亦本間題ニ就イテ上坂教授指導ノ下ニ詳細ナル檢査ヲ行ヘリ. 使用セル動物ハ家兎, 犬, 鼠ニシテv. Gierke氏法ヲ模倣シテ0.025%ノα-NaphtholトDimethylparaphenylendiaminトノ食鹽水溶液ヲ用ヒタリ. 檢査ノ結果次ノ如キ結論ヲ得タリ. 予ノ行ヘル檢査ノ成績ハ大體ニ於テ勝沼博士ノソレト大同小異ナリ. 中樞神經ノ灰白質ニ於テハ最初一般ニ瀰漫性ニ青染シヤガテ神經節細胞ニー致シテ著明ナル青色顆粒表ハル. 神經細胞核ハ本反應一般ニ陰性ニシテ微細ナル「インドフェノール」顆粒ヲ以テ充タサレタル細胞體ヨリ明カニ區別スル事ヲ得. 但シ小腦プルキンエ氏細胞,脊髓神經節細胞ハ例外ニシテ核小體ニ「オキシダーゼ」顆粒テ認メ得ルコトアリ. 尚ホ又脊髓前角ニ存スル運動神經細胞ハ其ノ核小體ハ多クノ場合極メテ微細ナル青色顆粒ヲ以テ充タサレタルヲ見タリ. 神經細胞ノ細胞體竝ニ其ノ樹枝状突起ハ微細ナル極メテ多數ノ「オキシグーゼ」顆粒ニテ充タサル之ニ反シ神經突起ニハ極メテ少數ノ青色顆粒存ス. 而モ一度青染セル切片ヲ室温中ニ放置スルニ神經突起ニ存スル青色顆粒ハ樹枝状突起ニ存スルモノヨリハ速ニ消失ス. 運動核ト知覺核トニヨリテハ「オキシグーゼ」反應ニハ差異ナキモノノ如シ, 然レドモ下橄欖ニ於テハ他ノ神經核ニ比シ其ノ「オキシダーゼ」顆粒ハ形稍大ニシテ其ノ數少キモノノ如シ. 中樞神經灰白質ハ全然「オキシダーゼ」反應陰性ナリ. 脊髓神經節ニ在リテハ同一種ノ細胞ト雖モ同樣ノ「オキシダーゼ」反應ヲ呈スルコトナク其ノ度極メテ種々ナリ. 強ク陽性ニ表ハルルモノハ多數ノ青色顆粒ヲ以テ其ノ細胞ヲ充タサルルニ反シ陽性ノ度弱キモノハ只核ノ周圍ニノミ極少數ノ「オキシグーゼ」顆粒存スルノミナリ. 斯ク種々ノ程度ニ染マリタル細胞ハ何等ノ配列ノ順序ナク不規則ニ混在ス. 中樞部ニ存在スル神經終末ハ三叉神經知覺繊維ニ就イテ檢スルニ「オキシダーゼ」反應陰性ナルモノノ如シ.
軸索ハ其ノ中樞神經細胞ヲ出テ極メテ僅カノ經過竝ニ末梢部終末ヲ除クノ外凡テ本反應陰性ナリ. Piamaterハ微ニ本反應陽性ナレドモ, 夫レガ神經繊維ト交叉シテ夫レヲ中樞部ト末梢部トニ區分スル部分ニアリテハ「オキシダーゼ」反應ハ全ク陰性ナルモノノ如シ.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811832007原発性肺高血圧症の進行メカニズムの解明と治療薬の開発187192ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812332011神経内科領域の難治性疾患診療227230ENYoshioIkedaKojiAbeNo potential conflict of interest relevant to this article was reported.岡山大学埋蔵文化財調査研究センターActa Medica Okayama252009津島岡大遺跡 19 ―第30次調査― （岡山大インキュベータ新営）ENNo potential conflict of interest relevant to this article was reported.Academic Press Inc Elsevier ScienceActa Medica Okayama0006-291X40942011Plural assay systems derived from different cell lines and hepatitis C virus strains are required for the objective evaluation of anti-hepatitis C virus reagents663668ENYoukiUedaKyokoMoriYasuoAriumiMasanoriIkedaNobuyukiKatoPersistent hepatitis C virus (HCV) infection causes chronic liver diseases and is a global health problem. HuH-7 hepatoma-derived cells are widely used as the only cell-based HCV replication system for HCV research, including drug assays. Recently, using different hepatoma Li23-derived cells, we developed an HCV drug assay system (ORL8), in which the genome-length HCV RNA (O strain of genotype 1b) encoding renilla luciferase replicates efficiently. In this study, using the HuH-7-derived OR6 assay system that we developed previously and the ORL8 assay system, we evaluated 26 anti-HCV reagents, which other groups had reported as anti-HCV candidates using HuH-7-derived assay systems other than ORB. The results revealed that more than half of the reagents showed different anti-HCV activities from those in the previous studies, and that anti-HCV activities evaluated by the ORB and ORL8 assays were also frequently different. In further evaluation using the HuH-7-derived AH1R assay system, which was developed using the AH1 strain of genotype 1b, several reagents showed different anti-HCV activities in comparison with those evaluated by the OR6 and ORL8 assays. These results suggest that the different activities of anti-HCV reagents are caused by the differences in cell lines or HCV strains used for the development of assay systems. Therefore, we conclude that plural HCV assay systems developed using different cell lines or HCV strains are required for the objective evaluation of anti-HCV reagents.No potential conflict of interest relevant to this article was reported.東京臨床出版Acta Medica Okayama0912-16332762011Surface-Based Registrationを利用した 3次元CBCTimageの重ね合わせとその応用例(2)99107ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812322011腹腔鏡下に摘出しえた上行結腸間膜発生のCastleman病の１例129132ENManabuNishieShinyaOtsukaJunTomodaKeishiFujiwaraWe report herein a case of mesenteric Castleman's disease which was confirmed on pathology. A 60-year-old man was admitted to our hospital complaining of abdominal pain. On the physical examination, there was no palpable mass. Computed tomography findings and magnetic resonance imaging revealed a well circumscribed, lobulated round mass on the right side of the superior mesenteric vein. Laparoscopic surgery for the mesenteric tumor was carried out to obtain a definite diagnosis and treatment. In the operative field, the mass was located on the ascending colic mesentery and measured about 3 cm in size. It was solid and surrounded by a thin fibrous capsule. The histological diagnosis of the mesenteric tumor was hyaline vascular type Castleman's disease. The postoperative course of the patient was uneventful, and he was discharged on the 10th postoperative day.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812322011医療訴訟における「医師の説明」に関する研究119127ENYoshiyukiFukumotoIn this study, a subset of medical malpractice lawsuits that are preventable was evaluated using qualitative data. The objective of this study is to help reduce the number of avoidable medical malpractice lawsuits. This qualitative study could pave the way to future quantitative studies. The analysis of the qualitative data revealed that in the vast majority of medical malpractice lawsuits filed by patients and their families there were @ an occurrence of unexpected bad outcomes, A inadequate explanation by the patient's physician, and B involvement of an instigator who encouraged the lawsuit. That is, the failure of a physician to provide an adequate explanation to a patient or the inappropriate conduct of a physician after unexpected bad results, with or without an instigator's involvement, is the main reason patients file medical malpractice lawsuits. The physician providing an adequate explanation to patients after unexpected bad results (adequate post-event explanation) is the pivotal determinative factor in preventing avoidable medical malpractice lawsuits.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2011The estrogen receptor influences microtubule-associated protein tau (MAPT) expression and the selective estrogen receptor inhibitor fulvestrant downregulates MAPT and increases the sensitivity to taxane in breast cancer cellsENHirokuniIkedaNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2011Infant’s bed climate and bedding in the Japanese home settingENRieIkedaNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812312011十二指腸潰瘍穿孔に対する治療法の適応についての検討3338ENNobuhiroIshidoRyujiTamuraTakahiroOkamotoYoshihikoKadowakiTakashiMoriBackground: Although conservative therapy has been acceptable as the first-line therapy for duodenal ulcer (DU) perforations, surgical therapies are known to have certain advantages. We investigated the indications for laparoscopic (LS) or open surgery (OS) or conservative therapy (CoT) among 56 DU perforation cases over 5 years. Methods: 31 LSs, 22 OSs and 5 CoTs were analyzed for patient's physical and surgical factors and clinical course. Results: Mean age was 51.6. Male/female ratio was 49/9. Survival ratio was 98%. Although the hospital stay (10.9 vs 19.5 days) and analgesic administrations (1.9 vs 4.6 days) were significantly shorter in LS than OS, almost all OS patients were in serious condition as evidenced by longer waiting time before treatment, stronger pain, bigger hole of perforation, more ascites accumulation and higher morbidity of complications. Two cases of multisurgery were experienced in both LS and OS groups due to leakage of seam, abscess formation, relapsed ulcer or idiopathic intestinal perforation. LS is a therapy more widely usable and more beneficial than the other two. Conclusion: LS, a minimally invasive surgery for DU perforation, should be considered as a first-line standard therapy because of significant advantages such as shorter hospital stay. OS or CoT may be selected when appropriate.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586711955再生不良性貧血（汎骨髓病症）の本態に関する研究 第三編 貧血の発生機転に関する実験的研究85105ENTakashiIkedaHaving performed various experiments about rabbits of experimental anemia, in order to clarify causes of anemia, by injection of anemia-producing substance, obtained results as follows: 1) As to spleen-extirpated rabbit, it has incurred anemia by injection of serum. 2) The same would take place in case of liver-disturbed rabbit, due to serum injection. 3) No anemia was observed with the same injection, when the reticuloendothelial system was blocked with Indian ink. 4) Injecting the serum at a, nutricia femoris, and investigating the blood picture at v, nutricia femoris discovered a marked decrease both in the number of erythrocytes as well as leucocytes 2 hours later. 5) The serum iron value has proved a rise at the maximum anemic stage, in the successive injection. 6) The myelogram of the rabbit in case of successive injection, indicated a picture of maturation-arrest. 7) By all these facts stated above, it might be said, as for the factor to renderrabbit anemic, blood cell-arrest within bone marrow could be considered on one side, while the disturbance in the parenchym of the bone marrow might be imagined on the other.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586711955再生不良性貧血（汎骨髓病症）の本態に関する研究 第二編 尿，髄液，諸臓器中の催貧血性物質6583ENTakashiIkedaThe author studied experimentally with the urine, cerebrospinal fluid, and extracts of bone marrow, spleen and the liver and obtained the results as follows; 1) In the urine, there is certain anemia-producing substance which is soluble in alcohol as well as ether, and exists in acid fraction. 2) In the cerebrospinal fluid, some anemia-producing substance could be discovered. 3) The bone marrow, the spleen and the liver have certain anemia-producing substance in their extracts.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586711955再生不良性貧血（汎骨髓病症）の本態に関する研究 第一編 血清中の催貧血性物質4363ENTakashiIkeda1) If inject serum of this disease in rabbits, in every cases where injected once, as well as 7-times-continued case, haemoglobin, erylhrocytes, as well as platelet indicate a marked decrease. 2) No anemia-producing substance will be seen in serum either of healthy person or of posthemorrhagic anemic patient. 3) Those anemia producing substances found in the patient of this disease proved soluble both for alcohol as well as ether. 4) These substances exist in acid fraction. 5) These substances have the thermostable character for the 30 minutes heating of 100°C.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586931957岡山県下に発生した流行性肝炎特に病原体に関する研究 分離病毒の感染スペクトルに就て833854ENAkiraIkedaIn this report, the problem of infectious spectrum of hepatitis virus was studied by observing the establishment of infection and passage in various kinds of animals. The virus isolated from the hepatitis patients in Okayama Prefecture was used throughout this work, and the establishment of infection and passage was judged by the pathological appearances, of tissues. particularly of liver as the center, of inoculated animals. The results were as follows: 1) In mouse, embryonated egg and young hamster, the infection and passage of hepatitis virus were established. 2) In rat, guinea-pig, young dog and young cat, the establishment of infection could not be proved with certainty. 3) Among the used strains of virus, some difference was observed, which was probably originated from the difference of conditions at the isolation and passage of them. It was not conceivable, however, that remarkable difference of pathogenicity was present among them. 4) Putting together the aspects of infection, pathological figures and general natures of virus from the results of animal tests, the virus used in the present work is very simillar to the one reported by Havens, Maccallum and Wildführ.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587112-11959大動脈起始部直視下手術における冠灌流の心電図学的研究 第2編 体外循環使用下冠灌流における心電図学的考察78917895ENJushinIkedaBoth retrograde perfusion via the coronary sinus and direct perfusion of the coronary artery during extracorporeal circulation were studied. Following results were obtained. 1) Coronary perfusion associated with extracorporeal circulation under normothermic condition is far better than with hypothermia in maintainance of cardiac physiology. All the experiments are successfully performed in the case of direct perfusion in this series. 2) It is important to keep perfusion pressure at optimal level during perfusion, which is 35 mmHg. in retrograde and 120 mmHg. in direct perfusion, respectively. Perfusion rate should be controlled within these optimal pressure in each case. 3) Blood flow to mycardium is well maintained in direct perfusion than in retrograde perfusion. Maximum circulatory cessation over 50 minutes is secured in the former method compared to less than 20 minutes in the latter. However, direct perfusion is technically difficult in practice and some divice is needed to facilitate its clinical application. It is preferable to choose one of both methods after direct inspection of valvular lesions following preliminary retrograde perfusion.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587112-11959大動脈起始部直視下手術における冠灌流の心電図学的研究 第1編 選択的脳灌流冷却法下冠灌流における心電図学的考察78797890ENJushinIkedaBoth retrograde perfusion via the coronary sinus and direct perfusion of the coronary artery during circulatory occlusion under selective brain cooling were studied and evaluated from the electrocardiographic standpoint. The following results were obtained. 1) Hypothermia is not applicable for this type of experiment because irritability of myocardium is increased by hypothermia resulting ventricular fibrillation. 2) Direct perfusion is more physiologic than retrograde perfusion and circulatory cessation is maintained over 50 minutes without deleterious effect to myocardium compared to only 15 minutes available in the latter method. 3) Perfusion pressure not exceeding 35 mm Hg. in retrograde perfusion and below 120 mm Hg. in direct perfusion are optimal to obviate mycardial damage which is manifested as ST-T deviation in electrecardiogram. It is safe to keep temperature of perfusion blood between 36 and 37°C. Blood containing over 7.2 gl/dl Hb is applicable for perfusion if oxygenation is satisfactorily attained.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587111-11959Ectromelia Virusに依る実験的肝炎の組織学的研究 第2篇 接種部位を変えた場合の体内諸種臓器組織の組織学的変化に就いて71117125ENTamotsuIkedaThe pathohistological changes of mice organ tissues were observed on the inoculation of ectromelia virus in the various changes of inoculated method and region. And the results were as follows. 1. The acute course was observed on the intraperitoneal inoculation, but it was subacute on the peroral and pernasal inoculation or the inoculation into the foot-sole. 2. The pathological changes of liver and spleen were diffuse on the intraperitoneal and peroral inoculation and it was local on the pernasal and subcutaneous inoculation or the in oculation into the foot-sole. 3. The change of intestine was the most remarkable on the peroral inoculation and the change of lung was the most remarkable on the pernasal inoculation. 4. The changes of organ tissues, other than those organs, were common to both of the occasions. 5. The presence of diffuse change in the organ was related to the density of invaded virus into organ and it was thought that the ectromelia virus was diluted by the systemic circulation. 6. The changes of liver and spleen were diffuse like epidemic hepatitis in human on the peroral administration and it was thought that bone of them showed a common infectious course.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587111-11959Ectromelia Virusに依る実験的肝炎の組織学的研究 第1篇 接種Virus量を変えた場合の諸種臓器組織の組織学的変化に就いて70957109ENTamotsuIkedaThe changes of various organ tissues were hirtologically observed per day on the intraperitoneal inoculation of ectromelia virus to mouse. And the results were as follows. 1. The changes of various organ tissures found at first was the findings accompanied by the functional and organic changes of blood vessel, the changes of lymph vessel system, reticuloendothelial cell system and connective tissue system, and was the remarkable appearance of perilobular tissue reaction including the wandering cells, and then the change extended to the parenchymal tissue and the various organ tissues became showing the special pathologic picture respectively. 2. The living period of animal was contracted with the increase of inoculated virus dosis. And there was quantitative difference, but no qualitative difference on the histological change at that time, and the convalescent process was not found at all and the infiltration of round cell was also very few in the cases with the exceedingly short living period. 3. The histological change was especially remarkable in the liver, spleen and bone marrow, and it was hemorrhagic alveolitis in the lung and the pathologic picture of nephronephritis in the kiduey. 4. The changes at the maximum stadium of the cases inoculatied the extremely high dosis of ectromelia virus were similar to those of the histological pictures of various organs in fulminant hepatitis of human and the changes at the maximum stadium of the cases inoculated the relatively high dosis of ectromelia virus were similar to those of the histological pictures of various organs at the maximum stadium of acute hepatitis in human. And the histological pictures of liver at the period from the inoculation to the maximum stadium and those of the animals being relieved of death were also similar to those, examined by the liver biopsy, at the period from the beginning to the maximum stadium and at the convalescent stndium in human hepatitis. 5. The pathologic pictures of mice with the inoculation of ectromelia virus were very similar to those of epidemic hepatitis in human and it was thought that both of them were based on the interlobular reaction.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558717-11959切除肺病巣内結核菌の生物学的，細菌学的性状に関する研究 第2編 切除肺病巣内結核菌と毒力について37833798ENHiroshiIkedaBy inoculating into the tail vein of mice 40 samples of culture positive bacilli obtained from different kinds of the excised pulmonary foci and by the estimation culture of the viscera of these test animals, the author studied the virulency of the tubercle bacilli, and also carried out observations on the relationship between the color reaction and the ability of cord formation. 1. Tubercle bacilli in the excised pulmonary focus generally tend to show a less potent virulency that that of H(37)Rv, human F strain, and ones isolated from human sputum. 2. However, the tubercle bacilli from the cavity expelling becilli up to the time of operation show the virulency almost as potent as the tubercle bacilli isolated from sputum. The longer the time after the cessation of bacillus expulsion the weakeer the virulency tends to be. In the caseous focus the virulency of bacilli tends to be less potent than in the case of the cavity. In addition, the softer the contents of the focus the weaker is the bacilli. 3. Tubercle bacilli in sll kinds of foci show no fixed relationship between the virulency on one hand and the size of focus, the kind and amount of drug administered befoer operation, and collapse therapy or no collapse theapy on the other hand. 4. Of various stainings, neutral red reaction in the case of extremely strong or extremely weak stain coincides well with the degree of virulency in the animal experiment, but in the case staining in an intermediate degree, although coinciding well with the potency of virulency, it does not necessarily agree with the results of animal experiment. It seems that this method is fairly useful for a rough estimatiou of the virulency of tubercle bacilli but it is not adequate enough for a precise analysis. Furthemore, P-K reduction test will yield the degree of virulency to a certain extent for the virulent strain, but for the determination of the degree of virulency in human infected bacilli, irrespective of the potency observed in animal experiment, no maked discoloration can be observed by this thst and it seems to possess no great significance. 5. No fixed relationship between the resistance against SM and PAS and the virulency toward mice, but in the case of INAH-resistant strain that acquired the resistance of over 10 γ, a weakening tendency can be recognized in their virulency. Such a tendancy has also been observed in the N-R reduction test. In addition, no decrease in the coloration can be recongized by the N-R reaction in SM-highly-resistant strain. 6. The cases showing the colony formation even after a long period of culture carried over 8 weeks amount to 12.7 per cent, but the number of colonies is small in all cases, snggesting a fall in the power of subsistence. However, the virulency is not necessarily diminished. Judging from the fact that with an exeption of the bacilli in the cavity expelling bacilli np to the operation, the potencyof the virulency and the power of subsistence in the majority of badillido not coincide with one another and that the virulency grows less potent along with the encapsulation and hardeniog of the foci, it is not difficult to understand that most of tubercle bacilli found in foci undergo physiological and bacteriological changes to a greaert extent than those tubercle bacilli usually found in the sputum of patient. Furthermore, in two caseous foci whose diamater is under 0.5 cm and whose contents are caseously hardened, the bacilli, though weak in viruleucy, have beeu found to be positive to the estimation culture. It is not reasonably impossible to say that such characteristic trait of tubercle bacilli may recover the virulency, and from such a reasoning there remains a problem to be solved before deciding definitively that the bacilli proving to be smear-positive and culture-negative are all dead.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558717-11959切除肺病巣内結核菌の生物学的，細菌学的性状に関する研究 第1編 切除肺病巣内結核菌の諸性状と耐性について37653781ENHiroshiIkedaOut of 207 cases of pulmonary resection, the author studied tubercle bacilli in 314 foci by smear, culture and estimation of resistance with the purpose to find out the characteristic traits of these bacilli, and obtained the following results. Smear positive ones occupy 94.2 per cent while culture positive only 45.2 per cent, and smear positive, culture negative ones occupy 49.7 per cent. The smear positive rate by various methods of staining is poorest in the case of Ziehl-Neelsen method and highest in the fluorescent method. There can be found no difference in the culture result whether cultured in an untreated 1% ogawa medim, 4% sodinm hydrocide-treated medium or untreated-3% ogawa medium. It seems that the question whether or not the tubercle bacilli in the focus are culture positive does not depend so much on the kind of chemotherapy, the dose of drug administered or duration of the treatment, but it rather depends on the character of the focus, and the effect of the chemotherapy affects indirectly ans secondarily, and that after the closing of focus and the hardening of contents with lapse of time smear positive-culture negative cases will increase in number. In the case given chemotherapy and collapse treatment prior to the resection, no fixed relationship can be observed in the cavity but in the case of the caseous cavity accompanied by penumothorax many culture positive ones can be recognized. In the case whose bacillib in the focus proved to be culture negative the majority of them show the normal value of the blood sedimentation before operation, and in these showing the value over 21 mm most of the bacilli in the cavity prove to be culture positive. The acquiring of resistance by the bacilli in the focus is dependent on the character of the focus rather than the dose of drugs or the duration of the treatment. In the open focus treated with a large dose of drug for a long period of time the resistance of bacilli in the focus is high, while the resistance of the bacilli in the encapsulated focus is generally low. However, even in the same kind of foci the resistance of bacilli tends to be higher in the foci whose contents are softer, and the same thing can be said of bacilli in different kinds of foci. Even in the cavity which stopped expelling bacilli soon after the start of chemotherapy, when the chmotherapy is continued for a long time afterward, generally there is no rising tendency in the resistance of bacilli in the focus. As for the degree of resistance acquired by bacilli against various drugs, the majority acquire a higher resistance against SM, and the resistance against PAS is on the whole low, while that ahainst INAH is approxiamtely similar to that against SM.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581013-41989ヒト骨・軟部腫瘍組織における癌遺伝子の解析285293ENHiroshiSumiiHajimeInoueShiroItoGozoTanabeHideoTakechiShogoIkedaTakuzoOdaThe amplification and rearrangement of five cellular oncogenes (c-myc, c-K-ras, c-fos, c-raf-1, and N-myc) were studied by Southern hybridization in fourteen human bone and soft tissue tumors obtained at surgery. Amplification of c-myc was detected in the two of four osteosarcomas and one of two malignant fibrous histiocytomas. The c-myc genes in these tissues were amplified 4- to 8-fold in comparision with the placenta DNA. One of these osteosarcomas had 16- to 32-fold amplification of c-raf-1 gene without rearrangement. The clinical course of osteosarcoma and malignant fibrous histiocytoma with the amplified c-myc or c-raf-1 gene showed a rapid malignant progress with lung or bone metastasis. There appears to be a correlation between clinical prognosis and oncogene amplification.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581029-101990一時的門脈遮断時における肝血流と酸素代謝に関する実験的検討11751185ENToshioIkedaThough numerous studies of systemic hemodynamics concerned with transient blockade of the portal vein exist, few studies have been performed specifically to assess blood flow and oxygen metabolism in the liver under such conditions.
We blocked the portal vein in adult mongrel dogs and measured systemic hemodynamics, hepatic blood flow, total oxygen delivery to the liver, and the oxygen consumption and extraction ratio in order to evaluate the effect of a blockade of the portal vein on hepatic oxygen metabolism. In addition, a portal vein bypass was established and its effect on the liver was evaluated in comparison to a simple blockade of the portal vein. The results suggested that arterial blood pressure and cardiac output declined severely upon simple blockade of the portal vein, and a decrease in total hepatic blood flow which could be avoided by establishing a portal vein bypass was also observed. Simple blockade of the portal vein maximally accelerated the oxygen extraction ratio, though oxygen consumption by the liver significantly decreased due to insufficient oxygen supply caused by the decrease in blood flow in the hepatic artery. With a portal vein bypass, however, blood flow in the hepatic artery did not fall, oxygen consumption was maintained at a constant level, and a moderate rise in the oxygen extraction ratio was observed. These results indicate that establishing a portal vein bypass may be useful to protect the liver.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581025-61990TPN下における糖,脂肪乳剤の至適配合比の検討 ―RI燃焼率，臓器内分布，生化学的検査,窒素出納よりの検討―663678ENAkihikoIkedaThe optimal fat/glucose ratio for TPN was determined, using oxidation and distribution of (14)C labeled fat emulsion and glucose. Animals were divided into five groups according to percentage of energy supplied as fat i·e. 0%, 20%, 40%, 60% and 80%, respectively.
(14)C-labeled fat emulsion and glucose were injected during TPN and the rate of oxidation to (14)CO(2) as well as (14)C distribution in various organs were measured. Oxidation of (14)C-glucose was constant in all groups and that of (14)C-labeled fat emulsion was inversely related to the amount of glucose administered simultaneously. (14)C-distribution in adipose tissue was correlated to the amount of glucose infused. As oxidation of glucose was significantly higher than that of fat, the higher the fat content of non-protein calorie, the less oxidation was observed. The groups given 60% and 80% energy composed of fat, showed less nitrogen retention and glycogen content in liver and muscle. These two groups exhibited high blood levels of free fatty acid, cholesterol and phospholipids. These findings suggest that the optimal blending ratio of fat would be around 20-40% of the non-protein calories.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812232010脈絡膜血管腫に対する放射線治療219223ENSosukeHaradaMitsuhiroTakemotoKoutarouYoshioKatsuhideKojimaNorihisaKatayamaKuniakiKatsuiMasahiroKurodaToshihikoMatsuoSusumuKanazawaPURPOSE: Circumscribed choroidal hemangioma is an uncommon, benign vascular tumor that typically appears in the posterior pole of the eye. Visual acuity loss typically results from its exudation, followed by serous retinal detachment. The purpose of the study was to evaluate the efficacy and the safety of external beam irradiation in treating circumscribed choroidal hemangioma. METHODS: We treated 4 eyes of 4 patients with circumscribed choroidal hemangioma with external beam irradiation at Okayama University Hospital from 2002 to 2009. A total absorbed dose of 20 Gy (beam energy, 4, 10 MV) was applied to each of the 4 patients. Each patient received a single 2-Gy daily fraction for five consecutive days in a week, for two consecutive weeks. RESULTS: In all cases, the retinal detachment showed complete resolution within 8 to 48 days after treatment. A decrease in tumor thickness was observed in all cases except one in which the follow-up period was rather short (3.7 months). The visual acuity improved in all 4 eyes. No eyes showed deterioration of visual acuity. During follow-up periods of 3.7 months to 58.5 months, there were no signs of radiation-induced cataract, retinopathy or optic neuropathy.No potential conflict of interest relevant to this article was reported.岡山大学埋蔵文化財調査研究センターActa Medica Okayama20082010岡山大学埋蔵文化財調査研究センター紀要2008ENNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5742003Differential responses of serum gamma-glutamyltransferase to alcohol intake in Japanese males.171178ENYokoMatsukaDa-HongWangNarufumiSuganumaKaoriImaiSatoruIkedaKazuhisaTaketaShoheiKiraArticle10.18926/AMO/32805<p>We studied the association of gamma-glutamyltransferase (GGT) and other serum markers of liver injury with daily alcohol consumption in a healthy population of 1,043 Japanese males. A positive correlation between daily alcohol consumption and biochemical markers, such as log GGT (r = 0.432), log AST (r = 0.244) or log LAP (r = 0.246), was seen in all drinkers. However, there was a negative correlation, such as log GGT (r = -0.434), log AST (r = -0.424) or log LAP (r = -0.430), in heavy drinkers who consumed more than 70 g ethanol a day. On the other hand, a positive correlation, such as log GGT (r = 0.426), log AST (r = 0.247) or log LAP (r = 0.216) was found in moderate drinkers who consumed less than 70 g ethanol a day. Interestingly, there was a tendency toward negative association between alcohol consumption and the Tokyo University ALDH2 Phenotype Screening Test (TAST) score in the heavy drinkers, and there was a tendency toward positive association between GGT and TAST score in this group. Our results suggest that there are 2 groups of drinkers, those with elevated GGT (good responders) and those with normal GGT (poor responders) despite heavy drinking.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5462000Epidemiological studies of coincidental outbreaks of enterohemorrhagic Escherichia coli O157:H7 infection and infectious gastroenteritis in Niimi City.265273ENKenjiTsumagariHidekiYamamotoNarufumiSuganumaMasahikoKatoSatoruIkedaKaoriImaiShoheiKiraKazuhisaTaketaArticle10.18926/AMO/32284<p>A sharp rise in the number of patients with infectious gastroenteritis was observed in the 25th week of year 1996 in the Takahashi-Ashin district by researchers with the Infectious Disease Surveillance Program for tuberculosis and other infectious diseases in the Okayama Prefecture. This sharp rise occurred coincidentally with an outbreak of enterohemorrhagic Escherichia coli O157:H7 (EHEC O157) infection in Niimi City of the Takahashi-Ashin district. However, this phenomenon of coincidental outbreaks was not observed during the outbreak of EHEC O157 infection in Oku Cho. By reviewing outpatients' charts in a sentinel hospital in Niimi City for the Infectious Disease Surveillance Program, it was noted that patients with acute gastrointestinal infection visiting the hospital during the increased incidence of infectious gastroenteritis may have been included as misclassified cases of EHEC O157 infection. On the other hand, the exponential probability plotting of symptomatic patients with EHEC O157 infection in Niimi City revealed a breaking point which suggested a dual exposure to contaminated food or an overlap with other acute gastrointestinal infections. The latter possibility was discounted, because stool culture-positive patients with EHEC O157 infection also exhibited a similar breaking point, and furthermore, the coincidental increase in infectious gastroenteritis in the same area was attributable to the EHEC O157 infection. The present study demonstrates the association between the sharp rise in gastroenteritis and the outbreak of EHEC O157 in the Takahashi-Ashin district. A careful analysis of the cases of infectious gastroenteritis by the Infectious Disease Surveillance Program would have predicted the outbreak of EHEC O157.</p>No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5552001Serum total cholesterol of new students enrolled at Okayama University: trend during 1989-1998.269276ENToshioOguraKazuharuMatsuuraHisaoSuzukiMasayukiKishidaSatoruIkedaChiakiTsukamotoAyumiImaiKazuoTobeArticle10.18926/AMO/32015No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X4031986Distribution of electrophoretically separated serum high density lipoprotein subfraction levels among healthy students and its alteration in patients with liver diseases.127138ENSatoruIkedaArticle10.18926/AMO/31934<p>In an attempt to evaluate high density lipoprotein (HDL) subfraction levels in liver diseases, HDL was separated by a precipitation method with dextran sulfate-Mg2+ from sera of 289 healthy adults and 50 patients with liver diseases. The HDL was subdivided into HDL2e and HDL3e by Utermann's polyacrylamide gel electrophoresis with lauric acid. Ultracentrifugally separated HDL2 and HDL3 roughly corresponded to HDL2e and HDL3e, respectively. Male and female groups had different distributions of HDL2e/HDL3e ratios. Among healthy males, 121 cases had ratios less than 1.0 (mean +/- SD = 0.72 +/- 0.39, n = 150), while among healthy females, the ratios were generally larger than those of males and varied widely from 0.2 to 6.6 (mean +/- SD = 1.77 +/- 1.05, n = 139). Low levels of HDL-cholesterol were found in patients with liver diseases, except those with mild alcoholic liver injury and intrahepatic cholestasis. Apparent decreases in HDL3e, but not in HDL2e, were found in all cases with liver diseases investigated, even in those who did not show decreases in the total HDL level, when male and female patients were analyzed separately. The analysis of HDL subfractions by the present method is simple and useful for the study on altered lipid metabolism in liver diseases.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5311999Seroepidemiologic Studies of Hepatitis C Virus Infection in a Population of Okayama Prefecture Screened for Liver Disease3138ENSeiichiroUesugiKazuhisaTaketaNirmalRimalSatoruIkedaTetsuKariyaNarufumiSuganumaHidekiYamamotoShoheiKiraArticle10.18926/AMO/31643<p>To better understand the spread of hepatitis C virus (HCV) infection, we studied the association of HCV infection with similarly transmissible hepatitis B virus (HBV) infection and with hepatitis A virus (HAV) infection, which is supposed to be related to a nosocomial transmission of HCV. This was done by studying the presence or absence of antibodies to these viruses, as well as hepatitis B surface antigen, in a population of 1,398 inhabitants with abnormal liver function tests or history of liver disease and/or blood transfusion. This group was drawn from a group of 7,905 examinees screened for liver disease in 26 districts of Okayama prefecture, Japan. The prevalence of antibody-positive cases increased with age for those viruses. Small but significantly increased odds ratios were obtained among anti-HCV antibodies (HCVAb), anti-hepatitis B core antibodies (HBcAb) and anti-hepatitis A antibodies (HAVAb). After adjusting odds ratios by logistic regression analysis, a significant association was present only between HCVAb and HBcAb. The distribution of age-adjusted prevalences (AAP) of HCVAb in 26 districts was significantly wider than those of HBcAb or HAVAb. The district-based AAP of HCVAb, but not of HBcAb and HAVAb, correlated significantly with the district-based prevalence of infectious hepatitis having a tendency of chronicity reported in 1953-1955. Adjusted odds ratios calculated by logistic regression analysis of the virus markers showed that HCVAb was significantly associated with a past history of blood transfusion. Thus, the spread of HCV infection is speculated to have been triggered by blood transfusion, particularly from paid donors initially, followed by transmission by nosocomial or close person-to-person contact.</p>No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5331999Urinary excretion of type I collagen cross-linked N-telopeptides, bone mass and related lifestyle in middle-aged women.133140ENChieMasatomiKaoriImaiDa-HongWangSatoruIkedaKazuhisaTaketaShinjiTakataShoheiKiraArticle10.18926/AMO/31637<p>The relationship between past and present lifestyle and urinary excretion of type I collagen cross-linked N-telopeptides (NTx) was studied in 61 Japanese females aged 34-59, with a view toward using NTx excretion rates as a predictor of future osteoporosis. Bone mineral density (BMD) of the lumbar spine, the speed of sound (SOS) and broadband ultrasound attenuation (BUA) of the os calcis, urinary NTx, serum osteocalcin (BGP) and bone-specific alkaline phosphatase (BAP) were measured. Stiffness index (stiffness) was calculated from SOS and BUA. The subjects were asked whether they took regular exercise in their childhood and teen years (in elementary, junior-high, senior-high school and college), the past (20-40 years of age) and present adulthood. Regular calcium intake, smoking habits, alcohol and other beverage consumption and milk consumption were also covered in the questionnaire. The mean NTx values of premenopausal and postmenopausal group were 22.2 and 56.0 nM bone collagen equivalents (BCE)/mM urinary creatinine (Cr), respectively. The group which did not exercise regularly between the ages of 20 and 40 had a higher mean NTx value (40.9 nMBCE/mMCr) than the group which did exercise regularly (22.7 nMBCE/mMCr). In multiple regression analyses, age, stiffness and exercise in past adulthood could explain 43.5% of the NTx variance. For prevention of bone metabolic increases around menopause, habitual exercise in early adulthood seems to be effective.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5231998Serum alpha-fetoprotein levels in healthy Japanese adults.149154ENHiroakiMatsuiNirmalRimalKozueKamakuraSeiichiroUesugiHidekiYamamotoSatoruIkedaKazuhisaTaketaArticle10.18926/AMO/31332<p>With advances in lectin affinity electrophoresis of alpha-fetoprotein (AFP), the detection of significant changes in serum AFP at low levels in cirrhotics has become important for early detection of hepatocellular carcinoma. Serum AFP levels of 616 healthy individuals without abnormal liver function tests or virus markers of hepatitis B and C were determined by enzyme immunoassay with IMx-AFP Dainapack using automated IMx apparatus set at twice the ordinary sensitivity and compared with those of 241 individuals with abnormal liver function tests and/or positive hepatitis virus markers. The coefficient of variation in this assay was less than 10% at AFP levels as low as 0.2 ng/ml with a lower detection limit of 0.1 ng/ml. The AFP level of healthy population showed a Gaussian distribution curve after logarithmic transformation with a median and 2.5-97.5 percentile reference range of 2.2 (0.6-5.6) ng/ml. There was no significant difference in the AFP level between males and females. Individuals with abnormal liver function tests alone showed no significant increase in serum AFP unless they were associated with positive hepatitis virus markers.
</p>No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5231998Wider Distribution of Salivary-Type Isoamylase Activity as Compared with Pancreatic-Type Isoamylase Activity in Serum: A Study on Young Female Adults143148ENMasakoNishimuraSatoruIkedaKazuhisaTaketaArticle10.18926/AMO/31329The clinical implications of a wider distribution of salivary type (S-type) isoamylase activity, as compared with that of pancreatic type (P-type) isoamylase activity in the serum of young female adults of 18-23 years old was studied. A high correlation existed between the S-type isoamylase levels in the initial determination and those in the second determination one year after on the same subjects, indicating that the wider distribution of S-type isoamylase level reflects an individual variation. The serum level of S-type isoamylase was highly correlated with the S-type isoamylase activity in saliva. Among the additional factors studied, a weak positive correlation was present between energy intake and the total and S-type isoamylase activities in serum. However, there was no negative correlation between the S-type isoamylase level and body mass index (BMI), which was reported for young male adults.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5231998Risk analysis of the exposure to GB virus C/hepatitis G virus among populations of intravenous drug users, commercial sex workers and male outpatients at STD clinic in Chiang Mai, Thailand: a cross-sectional case-control study.161167ENNarufumiSuganumaSatoruIkedaKazuhisaTaketaDa-hongWangHidekiYamamotoKannikaPhornphukutkulSupatraPeerakomeKriegsakSitvacharanumJaroonJittiwutlkarnArticle10.18926/AMO/31326<p>An exposure to GB virus C/hepatitis G virus (GBV-C/HGV) was studied among populations at risk for blood and sexual exposure to analyze risk factor of the transmission of the virus. Blood samples were drawn from 98 intravenous drug users (IVDU), 100 female high-class commercial sex workers (CSW) and 50 male outpatients (MOP) at a sexually transmitted diseases (STD) clinic in Chiang Mai, Thailand. These blood samples were analyzed for GBV-C/HGV RNA; antibodies against second envelope protein of GBV-C/HGV (anti-E2); anti-hepatitis C virus antibody (HCV-Ab); hepatitis B core antibody (HBcAb); and antibodies against human immunodeficiency virus (HIV-Ab). Prevalences of GBV-C/HGV RNA, anti-E2, HCV-Ab, HBcAb and HIV-Ab were 27.6%, 16.3%, 84.7%, 76.5% and 45.0% in IVDU; 0%, 21.5%, 2.0%, 72.0% and 11.0% in CSW; 6.0%, 13.6%, 0%, 64.0% and 14.0% in MOP. While the prevalence of GBV-C/HGV RNA was higher in IVDU than in CSW and MOP, comparable prevalences of anti-E2 among the three populations were found. Intravenous drug injection showed association with GBV-C/HGV RNA, while history of STD associated with anti-E2. In conclusion, intravenous drug injection and STD were found to be risk factors for the previous exposure to GBV-C/HGV, but STD did not increase the risk of the GBV-C/HGV viraemia.</p>No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X3521981Complete in vitro replication of SV40 DNA and chromatin in saponin-treated permeable cells.149154ENSatoruIkedaHideoNagashimaKazuhisaTaketaMakotoWatanabeBrief Note10.18926/AMO/31266<p>Effect of nicomol on high density lipoprotein (HDL) subfractions, HDL2e and HDL3e, separated by electrophoresis.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X3451980Interrelated changes in gamma-glutamyltransferase activity and HDL-cholesterol level in the sera of patients with alcoholic liver injury.293299ENTakeroIdeKazuhisaTaketaMakotoWatanabeSatoruIkedaMasakiIzumiTerukoSokabeHiroshiKonoYoshioYamamotoArticle10.18926/AMO/30548<p><p>The levels of HDL-cholesterol and gamma-glutamyltransferase in the sera of 17 patients with alcoholic liver injury were followed after abstinence and compared with those of 11 patients with acute non-alcoholic hepatitis. The activity of gamma-glutamyltransferase decreased in all cases irrespective of the type of liver injuries. The level of HDL-cholesterol also decreased in 11 of 17 cases with alcoholic liver injury. The other alcoholics, in whom HDL-cholesterol level increased or showed no definite change after withdrawal of alcohol, had severe and advanced liver injuries. In non-alcoholic hepatitis, the HDL-cholesterol level increased as normal liver functions were restored except for one case with cholestatic features. It was concluded that alcohol intake can increase HDL-cholesterol level even in the presence of a concomitantly induced hepatic lesion.</p></p>
No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2010Inhibitory Effects of Simvastatin on Platelet-derived Growth Factor Signaling in Pulmonary Artery Smooth Muscle Cells From Patients With Idiopathic Pulmonary Arterial HypertensionENTetsuyaIkedaNo potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama232006動物園と動物たち､そして人2225ENRyoichiAkasakoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812212010頚椎症性脊髄症の診療ガイドライン6771ENMasatoTanakaYoshihisaSugimotoHaruoMisawaTomohiroTakahataToshifumiOzakiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812212010DNA 損傷センサーATMキナーゼとChk2はＣ型肝炎ウイルスのRNA複製に必要である916ENYasuoAriumiMisaoKurokiHiromichiDansakoKenichiAbeMasanoriIkedaTakajiWakitaNobuyukiKatoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558775-61965腫瘍ウイルスの形態と分類795835ENKiyoshiHirakiZensukeOtaShozoIrinoIsaoMiyoshiTatsuoSezakiHideoHaradaShinyaSuzukiYoshimoriOhsatoTeiichiroNagamoriJunichiroMoriyaMasahitoMugurumaKiyoshiTakasugiHiroshiDabasakiKazuhikoIkedaMorphologic characteristics of most of known oncogenic viruses, some of which were investigated by us, were described in relation to their oncogenicity and their localizations in tumor tissues. Oncogenic viruses were classified into six groups: type A, B, C, D, E and F. Viruses pertaining to type A were presumably not mature virus particles. Some of them could, however, be immature form or incomplete form of oncogenic virus particles. Viruses belonging to type B, C, D, E, and F were represented by mammary tumor virus of mice, leukemia viruses of mice and chickens, polyoma virus, Shope fibroma virus and Lucke renal adenocarcinoma virus, respectively. They were different in size and shape, and in the mode of development. It was presumed that type B and C viruses were members of the Myxovisus group and type D viruses belonged to Adenovirus and the Papova virus group. It was also believed that type E and F viruses had in general the feature of the Pox virus group and Herpes virus group, respectively.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558761-31964持続性部分性てんかんの一症例4146ENTadashiHiramatsuShigeoYokoyamaHisaoIkedaMasatomoYamamotoWe reported a case of epilepsia partialis continua. Movements consist of almost continuous rhythmic jerking which is limited to the right lower limb. Angioma arteriovenosum was seen in the left parietal region on the angiogram of left carotid artery. The clonic jerk of this case was much improved on the anticonvulsants.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558829-101970三塩化エチレン気中濃度と暴露後の尿中，三塩化エタノール，三塩化酢酸の排泄量との関係 第1報 三塩化工チレン中毒の研究431434ENYoshikoTakatsukaIn order to know the relationship between concentration of trichloroethylne and the amount of urinary trichloroethanol or trichloroacetic acid, average concentration of trichloroethylene inhaled by the workers in an automobile parts factory was measured by Kitagawa detector tube at 20-minute's interval. And urinary trichloroethanol and trichloroacetic acid were determined by Ikeda's oxidation method of chromium trioxide and our direct colorimetric
method. The results were as follows. 1. Straight relationship between trichloroethylene concentration in the air and trichloroethanol or trichloroacetic acid in the urine was recognized by Ikeda's method. 2. Urinary trichloroethanol and trichloroacetic acid concentrations in workers exposed to trichloroethylene were determined by both our direct colorimetric method and Ikeda's oxidation method of chromium trioxide. Correlation between urinary trichloroethanol and trichloroacetic acid determined by Ikeda's method and our direct colorimetric method was observed.
泄されるのであろうと言つている.1946年,Forssman,Ahlmark(2)3))はトリクレン蒸気中で働く労働者の訴えと,その尿中三塩化酢酸濃度との関係を見い出し,その75mg/lがトリクレン中毒の警戒すべき限界であると報告した.これに対して,1950年,Frant,Westeadorp(4))は,環境に気中のトリクレン濃度100ppmのもとで働く場合,その尿中には200mg/l濃度の三塩化酢酸を含むと述べられている.現在までは,三塩化酢酸の許容濃度はFrantの成績より75mg/lであるとしている.又,トリクレンの尿中代謝産物には三塩化エタノールのグルクロン酸抱合物もあり,soucek and Vlachova(5))等は1964年に,三塩化エタノールは,三塩化酢酸より排泄量が多く,しかも,排泄速度がはやい事を報告している.著者は実際の作業場で,三塩化エタノール,三塩化酢酸の関係を調べ,気中濃度との関係を求めた.又,三酸化エタノールの定量を池田氏の方法に比べて,簡便な定量を見いだした.そして作業者の尿を用いて,著者等の方法と池田氏の方法との相関を調べた.その成績をここに報告する.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558811-21969Laurence-Moon―Biedl症候群の2例-精神症状を中心に8590ENHisaoIkedaIzumiHiramatsuTwo cases of Laurence-Moon-Biedl syndrome were reported with marked mental symptoms. Case 1 had mental defficiency, obesity, polydactylia and Retinitis pigmentosa, and was recognized periodic mental symptoms (repeated alternatively increased psychomotor activity and decreased psychomotor activity). Case 2 had mental defficiency, obesity, polydactylia and Retinitis pigmentosa, and was recognized constant mental symptoms (lacking in spontaneity, mutism, negativism and so on). The mental symptoms of Laurence-Moon-Biedl syndrome seems to be classified as two groups. That is, the first group has constant mental symptoms and the second group has periodic mental symptoms. Our Case 1 belongs to the second group and Case 2 belongs to the first group.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558863-41974間歇性経過と巨大なcystsで特徴づけられた聴神経腫の1剖検例157162ENShigetoshiKurodaJunTateishiMasakiChudaHisaoIkedaAkiraMorisadaA case of acoustic neurinoma with huge cysts was reported clinico-pathologically. A male developed at the age of 30, the left-sided hearing difficulty. At the age of 48, he noted the staggered gait which after a while almost entirely cleared up. At the age of 54, he was again unable to walk because of ataxia. Neurological symptoms at the admission to hospital were almost agreed with those in acoustic neurinoma. The symptoms showed complete remission partly because of medication, but they became worse rapidly again, The patient died from bronchial pneumonia at the age of 60. Autopsy disclosed a tumor with huge cysts at the left cerebello-pontine angle which was diagnosed neurinoma microscopically. The most unusual clinical point lies on the course. It lasted thirty long years and moreover displayed an intermittent course showing remission and exacerbation. Another point of interest is the huge cysts found in the tumor at autopsy. The authors discussed the cases manifestating atypical clinical course and tumors with huge cysts in the literature.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558811-21969著明なてんかん性要因を示し，挿間性昏迷状態をくりかえした非定型精神病の1例7183ENK.HosokawaS.NishimuraH.Ikeda症例は13才女子.患者の7親等にあたる父系に精神病者があつたというが遺伝歴の詳細は不明.既往歴に特記すべきものはない.本症例に招来した前後7回の昏迷状態と,その他幻覚妄想の表面化した,昏迷状態と異なる状態像をあわせ観察し,発病より入院に至る経過,及び前後2回の入院の経過を詳述した.昏迷状態はつよい無動無言を主兆とする分裂病性昏迷と区別のつかないもので,始まりは急で1日を境にして訪れ,2週間前後続き寛解をみる.この間認むべき意識障害はなく,患者は些細な出来事迄すべてを想起できる.前後18回の脳波による継時的観察を行なつた結果,昏迷状態下では,棘波を中心とする発作性異常波は抑制され,寛解期にはこれが出現しやすい傾向を認めた.昏迷状態はAmytal sodiumで,一時的ではあるが劇的に改善され, Valiumの大量内服でも臨床像を改善できた.しかし抗てんかん剤は,むしろ昏迷状態には奏効しなかつた.本症は精神病像からは非定型精神病群の1型としてみられるが,発作波の消長からは,てんかんにみられる所見と同一の傾向を有し,両者を結ぶ1点を鮮やかに示した1例であつた.非定型精神病のてんかん性要因はかかる症例の継時的観察から決定されるべきものであると考えた.その他昏迷状態の出現と,発作波の消長に関し,若干の生理学的推論を試み,考察を加えた.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558839-101971低髄液圧症候群の5症例311317ENHisaoIkedaHirofumiHigashiTakashiEbaraShinsukeKuboA report of clinical observation was made on the five cases of low cerebrospinal fluid pressure syndrome that we encountered recently. The age of these patients ranged from 27 to 40 years all being female. As for the causative factors of this condition, the puncture of lumbar spinal fluid appeared to be the cause in one case, the trauma of the head in one, but there could be found not any noteworthy cause for the rest of the cases. The subjective symptomes common to all were headache, nausea and vomiting, and the headache was of the nature to be aggravated on assuming the upright posture. Examinations revealed the low pressure of cerebrospinal fluid was the characteristic feature of this syndrome the maximum of which being 60 mmH(2)O. Otherwise, aside from an increase in the cell counts there could be observed no other noticeable abnormality. As for objective and neurological symptomes no other than bilateral extensor plantar responces and stiffness of the neck could be detected. The administration of hypotonic glucose solution into the vein and physiological saline solution into the subarachnoidal space proved to improve their symptomes and the prognosis was favorable in all.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558897-81977視神経炎に関する神経学的観察―その疫学と髄液所見―903911ENToshiyukiHayabaraSeisoYabukiHideakiFukuiMasakiChudaReikoNambaHisaoIkedaSaburoOtsuki原因不明のmonosymptomaticな視神経炎および視神経萎縮の60例に対し,アンケートによる初診後の経過を調べ,初診時の髄液検査(39例)の結果と合せ検討した.1)症例の発症年令は,思春期前および初老期後は著しく少なく,性別は男女同数だが,経過別にみると,緩徐発症慢性経過は男性に,急激発症反復は女性に多い.2)発症誘因に,発熱・感冒・過労などがあり, MSに類似する.3)後に神経症状を呈したのは6例で,急激発症例の15.4 % にあたる.うちMSへ移行したのは3例7.7 % である.球後視神経炎のみに限ると, 18例中3例16.7 % である.4)眼底所見,罹患側,臨床経過などを分析すると,各々,球後視神経炎,両側非同時性,急激発症反復型がMSへの指向を示す.5) 髄液では,軽度細胞数増多,軽度蛋白量増加を示す.蛋白分画ではalbuminの減少,fast α(2)-globulin＋transferrinの増加,γ-globulinの増加の他pre-albuminの増加がうかがえた.6)眼底所見別にみると,蛋白量は視神経炎で高値であるのに対し,IgG,IgG % は球後視神経炎で増加を示す.罹患側別にみると,片側性および両側非同時性においてγ-globulinの増加を認む.経過別にみると反復型およびMS移行群で,蛋白量, γ-globulinの増加を示す,又MS移行の3例中2例で,初回発作時にMS的髄液所見(γ-globulinの選択的増加, IgG, IgG % の増加)を示した.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558893-41977タヌキ,テン,アナグマ,イタチの膵管に寄生を認めたConcinnum ten (Yamaguti, 1939) Travassos, 1944について407417ENTetsuroSaitoSeiichiroTomitaSyujiIkedaDaigoroSakumotoYasumasaTonguSetsuoSuguriKazuoItanoSeiitiInatomiAn investigation on the helminths of wild animals (Martes melampus, Meles meles, Mustela sivirica, Myocastor coypus, Nyctereutes procyonoides and Vulpes vulpes) caught in the systems of the Chugoku mountains of Hiroshima and Okayama prefectures was done from December in 1970 to October in 1974. The worms, genus Concinnum, were found from the pancreatic duct of Nyctereutes procyonoides, Martes melampus, Meles meles and Mustela sivirica. The parasitic rate of Concinnum in Martes melampus is 100 % (the average number of parasites is about 3000), in Nyctereutes procyonoides 23.8% (40), in Mustela sibirica 20% (225) and in Meles meles 50% (9). The parasites were fixed with Schaudin's solution while compressed between slide glasses, stained with carmine solution and observed with the light microscope. All of the worms were identified with Concinnum ten (Yamaguti, 1939) Travassos, 1944 according to the measurement. The present paper is the first report showing that Concinnum ten was found from Meles meles and Mustela sibirica, and that these animals are also the natural final hosts of Concinnum ten.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558919-101979Differential Hypothermia処置の安全限界に関する実験的研究 第2編 家兎正常脳の代謝への影響13171332ENKomeiIkedaDifferential hypothermia (D.H.) treatment was performed on normal rabbit brains and the associated changes in cerebral metabolism were observed in series. Under generalized body hypothermia (rectal temperature; 23℃), a portion of normal brain was maintained at normothermia (37±1℃) by heating with microwave irradiation (2.45GHz). Brain tissues were sampled as follows; before treatment, at the beginning, 3, 6 and 10 hours later, and finally 12 and 36 hours after completion of the 10 hour-treatment. Five rabbits were studied in each group to be 35 as a total sum. In each rabbit, two samples; one from the normothermic portion and one from the hypothermic portion, were obtained. By using enzymatic analysis, six glycolytic metabolites (glucose, glucose-6-phosphate, fructose-1,6-diphosphate, dihydroxyacetone phosphate, pyruvate, lactate) and three adenine nucleotides (ATP, ADP, AMP) were investigated quantitatively. From these results, the ratio of lactate and pyruvate (L/P ratio) and energy charge potential (ECP) were calculated. Before the treatment, the L/P ratio was 26.4 and ECP was 0.921. Up to 6 hours after the beginning, the metabolic status in the normothermic portion was relatively higher than the hypothermic portion. Namely, L/P ratio and ECP in the normothermic portion reached 27.6 and 0.953 respectively. On the completion of the 10 hour-treatment, however, glucose decreased considerably. While G6P increased markedly associated with a L/P ratio of 47.5. Similarly ATP was decreased, while ADP and AMP were increased, therefore ECP decreased to 0.873. These data indicated tissue hypoxia. On the other hand, 36 hours after the treatment, the L/P ratio recovered completely to 18.7, ECP also recovered to 0.901. These results indicated that metabolism in the normothermic portion was smooth up to 6 hours duration of treatrent, although it was constantly higher than the hypothermic portion. On the completion of the 10 hour-treatment, increase of glycolysis by tissue hypoxia and failure of energy metabolism were observed. However, these changes were considered still reversible because the results obtained after the treatment indicated reasonable recovery. Therefore it was suggested that 10 hour-differential hypothermia treatment on the normal rabbit brains was safe from a viewpoint of glycolytic and energy metabolism.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558919-101979Differential Hypothermia処置の安全限界に関する実験的研究 第1編Microwave照射による脳加温に関して13011316ENKomeiIkedaDifferential hypothermia (D.H.) treatment (preservation of brain tumor at normothermia during generalized body hypothermia) for the treatment of human brain tumors requires the tumor to be heated throughly and maintained for the necessary time. The normal portion of brain has to be protected during and after the treatment. Microwave (MW) seemed the most suitable heating method, so its effects on the normal brain of dogs were studied. During MW irradiation, the thermistor-probe showed higher temperatures erroneously. When the probe was covered by aluminium foil, the measurement error was less than 0.2℃ as long as the probe was in the brain. This method sufficiently heated the brain under generalized hypothermia down to 2 cm in depth from the surface. The highest temperature was recorded between 0.5 cm and 1 cm in depth and was easily controlled by the output of MW. On the other hand, aluminium foil blocked MW irradiation completely, therefore the irradiation field possibly protected the normal portion. To study the safety limits of heating by MW irradiation, two groups of rabbits maintained at different temperatures (37℃ and 40℃) were prepared. Following D.H. treatment for 5 hours in each group, the rabbit brains were examined histologically. The results showed minimal brain damage by MW irradiation in the 37℃ group. In the 40℃ group, heat necrosis was constantly observed as well as stagnation of vessels and perivascular cuffing of round cells. From these findings, it was concluded that MW was useful as a heating method during D.H. treatment. The safety limit of heating was up to normothermia.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558921-21980岡山県におけるアルコール症入院患者の実態8592ENHSuwakiSHoriiHIkedaSOtsukiYNishiiSTakahashiAFujimotoA survey of inpatient alcoholics in Okayama Prefecture was carried out on September 1, 1977. Questionnaires for each alcoholic were sent to the psychiatrists of 23 psychiatric hospitals and wards (the total number of psychiatric beds was 4591). Psychiatrists from 21 hospitals (93.9% of the total beds) supplied data. There were 4198 psychiatric inpatients, of whom 230 (5.5%) were alcoholics. Of these alcoholics, 14 were women (6.1% of all alcoholics). Marked differences were found among the hospitals concerning the number of inpatient alcoholics. The number of senile alcoholics over 60 was high (49 persons, 21.4%) and many inpatient alcoholics (102 persons, 44.3%) continued admission for more than one year. The hospital bills of 110 alcoholics (47.8%) were paid by Seikatsuhogo (financial support by the Welfare Office) and obligatory admissions were only 3 (1.3%) of the total alcoholics. 83 of the guardians (36.1%) were spouses and 20 (8.7%) were mayors or village heads. 30.4% of them remained divorced. Thus, inpatient alcoholics had handicaps in family and economical backgrounds, and it is necessary to carry on treatment sufficiently supported by social work.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558947-81982非ヒストン蛋白質およびH1ヒストン除去のクロマチンの鋳型活性とヌクレアーゼ消化性への影響721727ENMinoruIrisawaShogoIkedaTakuzoOda真核細胞のクロマチンは,DNA,ヒストン,非ヒストン蛋白質の複合体であり,その基本構造は,4種のヒストン(H2A,H2B,H3,H4)の各2分子が会合した8量体(ヒストンコア)にDNAが約1.75回巻きついたヌクレオソームコアが連結DNAで数珠玉状に連なったヌクレオソーム構造の繰り返しであることが知られている(1)).またH1ヒストンはヌクレオソーム間の連結DNAに,クロマチンを折りたたむようについていると考えられている(2,3)).非ヒストン蛋白質の分子種は数百にも及び,生物種や細胞分化の過程で特異的な変化を示すことからDNAやRNA合成の調節の主役をなすと考えられている(4〜6)).ヒストンと非ヒストン蛋白質を選択的に核またはクロマチンから除去することによるクロマチンの形態変化の電顕観察(7)),転写鋳型活性への影響(5,6,8,9)),micrococcal nuclease消化への影響(10〜12))を研究することにより,ヒストン,非ヒストン蛋白質の機能の研究がされている.特にH1ヒストン除去によるクロマチンの構造と機能の変化の研究がよく行なわれている.これらの研究でH1除去の転写活性に与える影響については,促進的に働くとする報告(6,9))とH1除去では影響なくクロマチンにH1を添加することにより転写活性を抑制できるとする報告(8))とがある.またH1除去のmicrococcal nucleaseによるクロマチンDNAの消化に与える影響についても,消化DNA断片の大きさに変化があるという報告(10))とDNA断片の大きさに変化はなく,単にヌクレアーゼ感受性が高まるだけであるとする報告(11,12))とがある.本研究は,塩(NaCl)処理によりクロマチンからH1ヒストン,非ヒストン蛋白質を除去し,それによるクロマチン構造と機能の変化を転写鋳型活性とmicrococcal nuclease消化性の面から研究した.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558931-21981中央手術部における管理情報の処理143152ENTakijiArataYasuhiroWatanabeTaijiMurakamiNaotoshiMaedaYujiIkedaToshioTomitaToshitoMitsuoka中央手術部における過去のデータを詳細に分析し,その結果をふまえて合理的な手術部の運営方法に改めるべきであると考えた.そこで昭和53年度の全手術患者3,879例について,手術明細表に記載されている事項をコンピュータに入力し,必要に応じて種々のデータが引き出せるようなシステムを試作した.今までこのような解析ができなかった理由は,病名および手術名があまりに多岐にわたっていてコード化することが困難であったからである.今回改訂発表されたInternational Classification of Diseasesの日本語版は,あらゆる病名を網羅していて使いやすく実用的であることが確認できた.またわが国の社会保険診療報酬規定の甲表区分番号による術名コードも,普遍性と実用性の面ですぐれていることが実証できた.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2009A Novel Antiangiogenic Effect for Telomerase-Specific Virotherapy through Host Immune SystemENYoshihiroIkedaNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558975-61985SV40小型腫瘍抗原遺伝子のクローン化と抗原の精製419428ENShogoIkedaThe simian virus 40 (SV40) DNA fragment encoding small t antigen was cloned with expression vector pUC8 for the purification of small t-antigen. Small t antigen produced in Escherichia coli was a hybrid protein of 22,000 daltons which comprised about 6% of the total protein. Hybrid small t antigen maintained antigenic activity which was examined by Western-blotting and enzyme-linked immunoassay. Hybrid small t antigen was extracted from E. coli with urea and purified from a small t-antigen band in SDS-polyacrylamide gel. The purified antigen maintained antigenic activity.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558999-101987カルシウムチャンネル阻害剤verapamilの中枢モノアミン伝達物質の放出ならびに代謝に及ぼす作用 : methamphetamineおよびreserpineとの比較10711081ENMasaakiIkedaThe effects of chronic treatment with verapamil(VP) on monoamine release and metabolism in rat brain in vivo were compared with the effects of methamphetamine(MAP) and reserpine(RES). These drugs were administered to rats in drinking water for two weeks. The contents of monoamines (DA and 5HT) and their major metabolites(DOPAC, HVA and 5HIAA) in eight discrete brain regions were measured by HPLC-ECD. After treatment with VP, DA levels decreased in the nucleus accumbens(N.ACC) and the suprachiasmatic nucleus(SCN), but no significant changes were demonstrated in the metabolites(DOPAC, HVA). 5HT levels decreased in the N.ACC, SCN and amygdara(AMY), and 5HIAA levels decreased in the raphe dorsalis(RD). GABA contents were increased in the N.ACC. After treatment with MAP, DA levels decreased in the N.ACC, striatum(STR) and ventro-medial hypothalamic regions(VMH). No significant change was shown in the metabolites. 5HT contents decreased in the N.ACC, STR, AMY, VMH and RD. 5HIAA contents decreased significantly in the RD. After treatment with RES, DA levels decreased in the N.ACC, STR and SCN. HVA contents decreased in the N.ACC and SCN, though they increased in the LH and SN. 5HT levels decreased in the N.ACC, SCN, AMY and RD. High 5HIAA concentrations were found in the N.ACC, STR, LH and VMH. DA, DOPAC and HVA levels were reduced more in several regions by co-administration of VP and MAP than by MAP treatment alone. DA was lowered more in the RD and HVA was lowered more in several regions by co-administration of VP and RES than by RES treatment alone. The well known locomotor hyperactivity induced by MAP was enhanced by VP. The present study suggests that there are at least two classes of voltage-gated calcium channels in the central nervous system related to the release of monioamines, one sensitive to VP and other not. In addition, chronic VP treatment may have an inhibitory effect on the release and synthesis of monoamines.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558999-101987ヒト悪性胸腺腫に関する研究 第2編 ヒト上皮型悪性胸腺腫細胞株(MT-TY株)のハムスターへの異種移植10631069ENHiromasaIkedaA continuous cell line, which was designated as MT-TY, was established from an explant culture of human malignant thymoma (epithelial type) in our laboratory. In the present study, for the purpose of making an animal model of human malignant thymoma, MT-TY cells were transplanted into antilymphocyte serum-treated newborn hamsters. The MT-TY line was serially transplanted for 7 passages. When 1.2-11.0×10(6) cells were inoculated intraperitoneally, all of the 22 experimental animals developed invasive tumors. Of the 22 hamsters, ascites and pulmonary metastases were found in 16 and 4 hamsters, respectively. Histological characteristics of the tumors in hamsters were similar to those of epithelial type of human malignant thymoma. This animal model would be useful for various studies of human malignant thymoma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558999-101987ヒト悪性胸腺腫に関する研究 第1編 ヒト上皮型悪性胸腺腫細胞株(MT-TY株)の培養樹立とその性状10531061ENHiromasaIkedaA permanent cell line, MT-TY, has been successfully established in continuous culture from a metastatic lymph node of a patient with malignant thymoma (epithelial type). Most of the MT-TY cells grew in suspension with formation of cell clumps. The doubling time of the cells was 36 hours and the modal chromosome number was 68. The MT-TY line is considered to have originated from donor's thymoma cells on the basis of cytogenetic, morphological and chromosomal features.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558995-61987ラット腹腔肥満細胞からのアナフィラキシー性histamine遊離に対するdisodium cromoglycate, 6, 7-dihydro-6, 8, 8, 10-tetramethyl-8H-pyrano[3, 2-G]chromon-2-carboxylic acid(EAA)およびtranilastの抑制効果 -細胞外Ca(2+)の影響および交叉タキフィラキシーの成立-681690ENShigekiIkedaTo clarify the modes of the inhibitory action of DSCG, EAA and tranilast on histamine release, the effects of these drugs were studied on anaphylactic histamine release from rat peritoneal mast cells passively sensitized with mouse anti-ovalbumin serum. DSCG had a potent and dose-dependent inhibitory effect on the release in ordinary Hanks' medium, whereas its activity was far weaker in the absence of Ca(2+). No marked differences were observed in the inhibitory activities of EAA and tranilast, irrespective of the presence or absence of extracellular Ca(2+). The inhibitory effects of the three drugs declined with prolongation of time of drug treatment before antigen challenge (development of tachyphylaxis). Once mast cells were made tachyphylactic to one of the three drugs, such cells showed markedly decreased responses to the other drugs (development of cross-tachyphylaxis). These results suggest that some common processes are involved in the mechanism of inhibition of histamine release by these drugs. It is possible that these drugs bind to the same specific sites on the surface of mast cells.No potential conflict of interest relevant to this article was reported.岡山大學放射能泉研究所Acta Medica Okayama21949放射能泉に関する研究-9〜19-119EN10.18926/15519No potential conflict of interest relevant to this article was reported.岡山大学医療技術短期大学部Acta Medica Okayama0917-4494811997看護学生の老人施設実習前後の老人イメージ8590ENKumiWatanabeMasukoKondoNiwaOhtaToshikoIkedaMakikoMaedaTakeoOhta10.18926/152882週間の特別養護老人ホームの実習前及び実習後の学生の老人イメージを20項目の尺度を用いて調査した｡その結果,以下のことが明らかになった｡ 1. 実習後のイメージの平均得点は,｢ユーモアのない｣から｢ユーモアのある｣へ,｢生気のない｣から｢生気のある｣へと好ましい方向へ上昇し,一方｢経験に富む｣,｢穏やかな｣,｢現実的な｣は好ましくない方向へ変化した｡ 2. 3分の1以上の学生が実習後に特にイメージが変化した項目として｢ユーモアのない/ユーモアのある｣の項目をあげた｡ 3. 老人像は全体として｢暇な｣,｢弱い｣,｢孤独な｣という否定的な老人イメージと｢経験に富む｣,｢暖かい｣という肯定的イメージで捉えられており,このイメージは実習前後で共通していた｡実習前後では全体として老人像に大きな変化はなかったものの,実習によって,より活動的な老人イメージを抱き,より現実的に老人をとらえていることが明らかになり,A園での老人看護学実習は教育上意義のある実習であると評価した｡No potential conflict of interest relevant to this article was reported.岡山大学医療技術短期大学部Acta Medica Okayama0917-4494911998老人の退院時における生きがいと生活行動および生活信条との関連3339ENKumiWatanabeYoshikoNakanishiToshikoIkedaSetukoTakataMasukoKondoNiwaOhtaHikariInoshita10.18926/15273退院を控えた老人が,どの程度生きがいを持って退院していくのか,老人自身のどのような生き方が生きがいに影響しているのかについて知るため,それまでの健康状態や,生活信条,生活行動について,退院許可の出た70歳以上の患者92名を対象として,独自の調査用紙に基づき面接調査を行った｡生きが
いとこれまでの健康度,生活信条,生活行動の関連性を,分散分析及びt検定により解析した｡生きがいの平均得点が高かった生活行動は｢ボランティア｣で,続いて｢植物｣であった。生きがいの平均得点が高かった生活信条は｢その日を楽しく生きる｣と回答した人が,回答しなかった人との間に有意差があり,老人の退院時の生きがいの得点が高い傾向を示すことが明らかとなった｡No potential conflict of interest relevant to this article was reported.岡山大学医療技術短期大学部Acta Medica Okayama0917-4494911998在宅看護における訪問看護内容の検討 ―病院を基盤とする訪問看護ステーションの事例調査―2331ENYoshieSatoKayoTakahashiToshikoIkedaMutsumiMatsuedaKanouYanagawa10.18926/15272病院を基盤とした在宅看護提供機関における在宅看護の現状を調査し,在宅看護の現在の問題点を明らかにするとともに,在宅看護に携わる看護婦の役割について検討した｡本調査の結果,一人暮らしの患者は,家族に介護者のいる患者に比べ明らかにADLが高い場合も訪問看護を受けていることが分かった｡また,高齢者夫婦二人暮らしの患者と2世代以上家族の患者のADLに差はなく,このことは,高齢の介護者に相当の負担がかかっていると言える｡訪問看護内容としては, 日常生活自立度の低い患者への日常生活援助の実施率は高く,精神的支援や指導的看護技術の実施率は低かった｡在宅看護に携わる看護婦は, 日常生活援助に追われがちであるが,一次予防に焦点を当てたケア,患者や介護者の精神的支援,指導,ケアマネジメントを行うことは緊急の課題である｡No potential conflict of interest relevant to this article was reported.岡山大学医療技術短期大学部Acta Medica Okayama0917-4494821998学生の自己評価による成人看護実習の達成度 ―3週後･5週後の自己評価結果の分析―147155ENNiwaOhtaToshikoIkedaNobukoOhiJingoKageyamaNaomiKanaoYuKobayashiYukoHayashi10.18926/15264この研究目的は,実習目標の達成度に対する学生の自己評価を明らかにすることである｡調査対象は短大の看護学科3年生74名である｡調査は自記式の調査票により成人看護実習の3週後と終了時の5週後に行った｡この自己評価は実習目標11項目について5件法で行った｡その結果,患者理解,患者指導,自己の内面の気づきなど目標は,3週後より5週間の実習によってより評価が高くなった｡最も自己評価が低いのは社会資源の活用の理解であった｡悪性の患者を受け持った学生の方は良性の患者の受け持ち学生より,人間としての態度や死生観などに関して5週後有意に高値であった｡今後の課題は,限られた実習期間内で,学生個々の経験をどのように共有させるかや患者の福祉について理解を深めることである｡No potential conflict of interest relevant to this article was reported.岡山大学医療技術短期大学部Acta Medica Okayama0917-4494921999看護学生の適性に関する尺度開発の試み ―信頼性･妥当性の検証―6574ENToshikoIkedaIsaoKondohKojiTanaka10.18926/15250看護教育では,看護者として必要な知識,技術のみならず看護するのにふさわしい態度や姿勢等を育成することを重視している｡このような看護者にふさわしい態度形成を援助する教育の成果を評価するために看護学生の適性に関する尺度開発を試みた｡尺度に用いる項目は,看護者にふさわしい態度や性格特性及び適性等に関する過去の文献調査と筆者等の臨床看護及び看護教育の経験とで検討し決定した｡最終的に絞り込んだ項目は,22項目であった｡この項目の信頼性･妥当性を検証するために,医療技術短大の看護学生206人を対象に質問紙調査を実施した｡信頼性については,76人を対象に再検査を実施し安定性を検討した｡その結果,相関係数の一番低い項目は｢研究心｣｢自制心｣で,0.36であった｡残りの項目は,相関係数0.40以上で,一番高い項目は｢冷静｣の0.71であった｡内的整合性を示すCronbach's α信頼性係数は,全項目では0.83であった｡因子分析の結果得られた5因子に基づく下位尺度のCronbach's α信頼性係数は,最も高いものは<リーダーシップ>0.80であり,最も低いものは<精神的成熟>0.56であった｡構成概念の妥当性を検討するために因子分析をおこなった結果,5因子が抽出された｡それぞれを<リ
ーダーシップ><社会性><探求心><精神的成熟><忍耐>と命名し,下位尺度とした｡No potential conflict of interest relevant to this article was reported.岡山大学医学部保健学科Acta Medica Okayama1345-09481212001山陽地方のカニにおける吸虫Spelotrema capellaeのメタセルカリアの感染状況1518ENTetsuroSaitoMitsuoKuyaMasahiroHashiguchiFumioIkedaHiroyukiYamaguchiKunieYoshidaYasumasaTongu10.18926/15238吸虫Spelotrema capellaeの飼い猫への感染源を調べるために,広島県福山市を中心とした瀬戸内沿岸の河口域に生息するカニにおけるメタセルカリアの感染状況を調査した｡調査地のうち広島児内の4ヵ所と岡山県内の1ヵ所のケフサイソガニHemigrapsus PenicillatusからS. capellaeのメタセルカリアが検出された｡特に,過去に症例報告のあった猫の行動圏内にある福山市の2ヵ所のケフサイソガニからは高率に検出された｡したがってこれらの地方においては飼い猫へのS. capellaeの感染源は河口産のケフサイソガニであることが強く示唆された｡No potential conflict of interest relevant to this article was reported.岡山大学医学部保健学科Acta Medica Okayama1345-09481612005リプロダクティブステージからみた月経痛の実態5766ENTomokoIkedaHiroyukiOkuda10.18926/1518418〜52歳の月経周期のある健康な女性193名を10代,20〜24歳,25〜34歳,35歳以上の4つのリプロダクティブステージに分類し,月経及び月経痛に関する実態調査を実施した｡結果@規則的な月経周期の割合は,リプロダクティブステージが進むにつれ増加し,経血量は減少傾向を示した｡A月経痛はリプロダクティブステージの進行と共に軽減し,鎮痛剤使用頻度,日常生活への影響が少なくなる傾向を認めた｡B各リブログクティブステージの特徴は,10代では月経痛の頻度や日常労作への影響が最も多く,血塊の出現率が最も高率であった｡20〜24歳は10代と類似していたが,鎮痛剤使用頻度は最も高率であった｡25〜34歳では最も安定した性成熟状態を示し,月経痛は｢時々あり｣が最も高率であったが,血塊の出現率が高かった｡35歳以上では月経痛のない人が最も高率であり,生活への支障が最も少なかったが,｢1日3回以上｣の鎮痛剤使用は他のリプロダクティブステージと変わらなかった｡以上の結果に加えてリプロダクティブステージにおける月経周期や経血量の特徴を考えあわせると,身体的な性成熟機能と心理社会的側面を考慮し,各リプ
ロダクティブステージに適した月経痛への対応が必要であると考える｡No potential conflict of interest relevant to this article was reported.岡山大学医学部附属病院三朝分院Acta Medica Okayama0918-7839661995温泉療法と気管支喘息患者のQOL7277ENYoshiroTanizakiTakashiMifuneFumihiroMitsunobuKazuhiroKajimotoYasuhiroHosakiSatoshiYokotaKojiOchiHideoHaradaSatoruIkedaKazuhisaTaketa10.18926/15127気管支喘息のなかでも,ステロイド依存性重症難治性喘息では,気管支拡張薬その他の抗喘息薬のみでは発作のコントロ-ルが極めて困難であり,したがって副腎皮質ホルモンの長期投与を余儀なくされる｡そして,投与薬剤,特に気管支拡張薬の心臓刺激作用や副腎皮質ホルモンの副作用,さらには運動誘発喘息がひき起こされやすいなどの理由により,体動制限が加えられることが多い｡このことが,また精神活動の低下へとつながる｡したがって,重症難治性喘息患者のQuality of life (QOL)を高めるためには,薬剤の副作用をできるだけ低くするための投与薬剤の減量をはかるとともに,十分な運動のもとに治療を行い全身状態の改善,それにともなう精神活動の活性化をはかる必要がある｡かかる観点からすれば,温泉療法は最も理想的な治療法であり,その直接作用(気道への作用:気道浄化作用,気道粘膜正常化作用)により,白,他覚症状の改善,換気機能の改善,気道過敏性の低下などが観察される｡また,間接作用(気道以外への作用)により,全身状態の改善,自律神経系の安定化作用,副腎皮質機能の改善作用などが見られる｡すなわち,重症難治性喘息に対する温泉療法では,十分な運動のもとに,精神活動の活性化をともなった喘息症状の改善がはかられるため,患者のQOLをより一層高めることができると判断される｡No potential conflict of interest relevant to this article was reported.岡山大学医学部附属病院三朝分院Acta Medica Okayama0918-7839661995Serum cortisol levels in patients with bronchial asthma. Relationship to glucocorticoid therapy and patient age.3036ENYasuhiroHosakiTakashiMifuneFumihiroMitsunobuKazuhiroKajimotoSatoshiYokotaYoshiroTanizakiKojiOchiHideoHaradaSatoruIkedaKazuhisaTaketa10.18926/15121Serum cortisol levels were examined in 94 patients with bronchial asthma in relation to dose of glucocorticoids and age. 1. The level of serum cortisol was significantly lower in group A patients, treated with glucocorticoids (prednisolone of 5mg/day or more) for more than 2 years, (2.4±1.2mcg/㎗) than in group B, treated with glucocorticoids (prednisolone of 5mg or less) for less than 2 years, (6.8±3.7mcg/㎗) (p<0.001) and in group C, treated without glucocorticoids, (12.6±3.9mcg/㎗) (p<0.001). The serum cortisol level was also significantly lower in group B than in group C (p<0.001). 2. The level of serum cortisol was significantly lower in patients over the age of 70 compared to that in those aged between 0 and 39 years (p<0.01) and those between 40 and 49 (p<0.05), and those between 50 and 59 (p<0.02). The level was also lower in patients between 60 and 69 compared to that in
those between 0 and 39, however, this was not significant.
These results demonstrate that the level of serum cortisol decreases by long-term glucocorticoid regimen and with aging.No potential conflict of interest relevant to this article was reported.岡山大学医学部附属病院三朝分院Acta Medica Okayama0918-7839661995Characteristics of ventilatory function in clinical types of bronchial asthma in the elderly2129ENYasuhiroHosakiTakashiMifuneFumihiroMitsunobuKazuhiroKajimotoSatoshiYokotaYoshiroTanizakiKojiOchiHideoHaradaSatoruIkedaKazuhisaTaketa10.18926/15120Ventilatory function was examined in 55 patients with asthma (25 older patients over the age of 60 and 30 younger patients under the age of 59) in relation to four clinical types classified by clinical symptoms and signs.
1. Regarding cellular composition of bronchoalveolar lavage (BAL) fluid, number of BAL neutrophils was significantly increased in type II, bronchiolar obstruction type, of older and younger patients compared to that in type la-1 and type la-2 of same patients. In contrast, BAL eosinophilia was observed in type la-2 of both older and younger patients and in type Ib of younger patients. 2. The values of % FVC, FEV(1.0%) and % PEFR were not significantly different among four clinical types of asthma and between older and younger patients, although the values of these ventilatory parameters in type II asthma showed a tendency to be lower compared to other clinical types. 3. The values of % MMF, % V(50), and % V(25), showing ventilatory dysfunction of small airways, were lowest in type II asthma of both older and younger patients among four clinical types. A significant difference in these ventilatory parameters of type II asthma compared to type la-1 asthma was observed in younger patients, but not in older patients. These results show that ventilatory dysfunction of small airways is related to clinical asthma types in younger patients, and to aging rather than asthma types in older patients.No potential conflict of interest relevant to this article was reported.岡山大学医学部附属病院三朝分院Acta Medica Okayama0918-7839661995Decrease in histamine release from bronchoalveolarcells with aging in patients with atopic asthma sensitive to house dust mite17ENYoshiroTanizakiTakashiMifuneFumihiroMitsunobuKazuhiroKajimotoYasuhiroHosakiSatoshiYokotaKojiOchiHideoHaradaSatoruIkedaKazuhisaTaketa10.18926/15117Histamine release from bronchoalveolar cells induced by house dust mite (HDm) was compared in patients with atopic asthma sensitive to HDm in relation to age. 1. Total cell number in bronchoalveolar lavage (BAL) fluid was larger in
patients over the age of 40 years (9.10×10(6)) than in those aged between 20 and 39 years (6.25×10(6)), however, this was not significant. 2. Number of BAL eosinophils was not significantly different between the two age groups. 3. Number of BAL basophilic cells was significantly higher in younger patients (20-39 years) (1.85±1.03×10(2)/mℓ) than in older patients (40+ years) (0.39±0.24×10(2)/mℓ) (p<0.001). 4. Histamine release from BAL cells induced by HDm was significantly higher in younger patients (38.1±24.8%) than in older patients (0%) (p<0.001). These results suggest that histamine release from BAL cells in patients with HDm allergy decreases with aging.No potential conflict of interest relevant to this article was reported.岡山大学教育学部附属教育実践総合センターActa Medica Okayama1346-3705912009習得と探求を活用でつなぐ算数授業改善の方策6372ENToyooKurosakiManabuSatoSadatoshiYamano10.18926/15105｢ゆとりの中で生きる力｣の育成を重視した学習指導要領が改訂され､｢習得｣｢活用｣｢探究｣を強調した新学習指導要領が2008年に告示された｡教育課程の国際的通用性が強調され､算数教育においても､習得と探究を活用でつなぐ授業改善が求められている｡ゆとり教育では､指導内容が30%､指導時数が14%縮減されたため､学力低下論議が過熱化してきている｡昨年度及び本年度とも実施された全国学力調査において､活用力には課題があると報告された｡このため､算数科においては活用力の育成が算数の授業改善の喫緊の課題としてクローズアップされている｡そこで､｢習得｣｢活用｣｢探究｣教育における｢活用｣の位置づけ明確にするとともに､算数科で活用力を育成するためにどんな授業改善をすべきか､その方策を検討する｡No potential conflict of interest relevant to this article was reported.岡山大学医学部附属病院三朝分院Acta Medica Okayama0918-7839671996Type U (bronchiolar obstruction) asthma and number of neutrophils in bronchoalveolar lavage (BAL) fluid7984ENYoshiroTanizakiTakashiMifuneFumihiroMitsunobuYasuhiroHosakiKozoAshidaSatoshiYokotaHirofumiTsugenoKazuakiTakeuchiYuichiroNawaKojiOchiHideoHaradaSatoruIkedaKazuhisaTaketa10.18926/15091Bronchial asthma is classified into three types ; type Ia (Ia-1 and Ia-2), type Ib, and type U, by clinical symptoms (clinical diagnosis). Asthma is also classified by clinical findings and examinations (score diagnosis). Both classification systems show that markedly increased proportion of BAL neutrophils and marked decrease in % V25 value are characteristic of type U, bronchiolar obstruction, asthma. However, there are some type U asthma patients without BAL neutrophilia. In these patients, age is higher compared to those with BAL enutrophlia. Decrease in FEV1.0% value and decrease in the proportion of BAL lympocytes and serum IgG level, are not so remarkable as decrease in those with BAL neutrophilia. It has been suggested that type U asthma with BAL neutrophilia correlates with suppression of humoral and cellular immunity, and same type of astma without BAL neutrophilia is in part caused by aging.No potential conflict of interest relevant to this article was reported.岡山大学医学部附属病院三朝分院Acta Medica Okayama0918-7839671996Evaluation of Body Surface Temperature by Thermography6370ENYasuhiroHosakiYuichiroNawaKazuakiTakeuchiHirofumiTsugenoKozoAshidaSatoshiYokotaFumihiroMitsunobuTakashiMifuneYoshiroTanizakiKojiOchiHideoHaradaSatoruIkedaKazuhisaTaketa10.18926/15088Body Surface Temperature was observed by thermography. The surface temperature of a healthy person's lower limbs, after being cooled in a water bath, increased in parallel with time. Patients with Diabetes Mellitus had different patterns in the rate of increase of the surface temperature. After cold loading, one patient had a 99% recovery ratio of surface temperature, the same level as healthy volunteers (83%, and 88%), as calculated by a picture processing program with the computerized thermotracer. However, the recovery ratio of other patients was poorer, ranging from 56% to under 6% recovery. This measurement of elevation of body temperature is useful for the estimation of peripheral blood flow in patients with lower limbcirculation failure.No potential conflict of interest relevant to this article was reported.岡山大学医学部附属病院三朝分院Acta Medica Okayama0918-7839681997通院患者の温泉プール利用状況とその臨床的評価7179ENNobukoNishimuraHayakoKasuiKeikoYoshioAkemiNakamuraAkikoIkedaYumiFukuiMayumiIgaAkikoKuroda10.18926/149901996年4月より6月までの3ヵ月間に,三朝分院内の温泉プールで水泳ないし歩行訓練を受けた内科外来患者は延べ2109例(実数213例)で,外来患者総数(延べ6848例)に対する利用率は30.8%であった｡これらの対象症例について,リハビリテーション受診カードにより,性別,年令別,疾患別の検討を行った｡その結果,性別では女性が多く(72.3%),年齢別では50才以上の患者が多い(80.3%)傾向が見られた｡また,地域別検討では,鳥取県内からの患
者が多い(88.3%)傾向であった。さらに,1996年12月より1997年1月へかけて,アンケート調査を行い(集計数;64例)継続期間,利用回数,効果を感じた期間,効果のあった症状などについて疾患別に比較検討した｡その結果,慢性閉塞性肺疾患を主とした呼吸器疾患では,週に1〜2回の利用回数(50.0%)で長期間(3年以上:52.9%)続けている患者が多い傾向であった｡また慢性関節リウマチ,腰痛などの慢性疼痛性疾患では,訓練期間は比較的短期間であっ
たが（3年以下:52.9%),利用回数は週に3〜5回(38.0%)と多い傾向が見られた。温泉プール訓練では,疾患本来の症状改善に加えて,全身状態の改善,精神的リラックス,気分転換などを感じていることが示唆された｡No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812112009イレウス症状で発症した小腸アニサキス症の１例2527ENSayakaFujiiManabuNishieRyousukeHamanoNaoyukiTokunagaYousukeTsunemitsuShinyaOotsukaKazuyaMiyoshiMasahikoTakahashiMasaruInagakiToshihideOosakiHiromiIwagakiWe report a surgical case of intestinal anisakiasis in which we identified a complete larva. A 48-year-old man complaining of epigastralgia after eating roasted mackerel was admitted to the hospital with a diagnosis of ileus with peritonitis. Abdominal CT showed dilatation and partial thickening of the small intestine. An emergency operation was carried out. On laparotomy, severe stricture of the jejunum was revealed. The affected intestine was resected. A larva whose head was invading the mucosa was found in the resected portion of the jejunum, and we diagnosed the case as intestinal anisakiasis.No potential conflict of interest relevant to this article was reported.岡山大学保健環境センター環境安全部門Acta Medica Okayama0917-1533282006東アジアの季節サイクルや日々の気象に注目した最終氷期頃の気候環境の理解へ向けて1727ENKuranoshinKatoShoichiroIkedaKanaAbeRegional climate system in East Asia shows the characteristic seasonal cycle affected by the Asian monsoon with various types of its sub-systems. The seasonal cycle there is also related greatly to behaviors of the frontal zones which are the boundaries of these sub-systems. Since the variation of global-scale environment such as the global warming influences on each monsoon sub-system in rather different manner, it is necessary to understand the joint effects of these subsystems, in order to predict the regional climate change in East Asia in the global warming. In such research, it would be also useful to examine the features in the ice age, as an opposite extreme situation against the global warming. Thus the present paper will discuss some viewpoints in investigating the regional climate in the Last Glacial Maximum with attention to the seasonal cycle and daily meteorological systems.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587861966腫瘍ウイルスの電顕的研究 第2編 C3H系マウスに自然発生した乳癌のウイルス粒子に関する電子顕微鏡的研究655664ENKazuhikoIkedaSpontaneous mammary carcinoma of C3H mice was studied by electron microscopy.
Cancer cells showed prominent nucleoli and increased nucleocytoplasmic ratio, containing a few mitochondria, vacuoles, and endoplasmic reticulum in the cytoplam. There were inclusion bodies in some of cancer cells.
Mature virus particles were seen in the lumina of the milk ducts, intercellular space and intracytoplasmic vacuoles. They were round in shape and composed of an eccentrically-located, electron-dense nucleoid containd in a triple-layered shell ranging 100 to 120 mμ in diameter. It was demonstrated that the outermost layer of the shell consists of numerons 100 Å spines. This finding is closely consistent with the negative contrast figure of the mature virus particles.
A new interpretation of type A particles was also presented.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990MR 画像データベースシステムの開発とその臨床応用に関する研究165176ENToshiakiNoriyasuA magnetic resonance (MR) image detabase system has been developed. The purpose of this paper is to present this system and its application. It consists of an image processing system and database system to handle data of clinical cases and a medical knowledge base. Using the image processing system and the database system with stored data of clinical cases, the MR image data of cases can be retrieved by diagnosis as well as ID number, patient's name, etc., and MR images can be processed. By using the database system with the medical knowledge base, differential diagnoses can be offered.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810311-121991脂肪（MCT）および高濃度分枝鎖アミノ酸を含有した成分栄養剤の侵襲下における効果12531265ENKazunagaSuehiroThe effects of a new enteral diet (ED-9) that was mainly composed of BCAA enriched amino acids, MCT and maltose were examined. Rats were subjected to small bowel resection and were administered two different formula for 7 days. The animals were divided into the following four groups : Sham operation and ED-9 (Group A), sham operation and control diet (Elental) (Group B), small bowel resection and ED-9 (Group C), and small bowel resection and control diet (Group D). Body weight loss after operation was similar in both ED-9 and control diet groups. Nitrogen balance and uninary 3 Methy1-histidine excretion demonstrated that ED-9 tended to improve protein preservation. Rats given ED-9 showed elevated ketone bodies and plasma BCAA level but these levels were not extraordinarily high. In conclusion, the formula of enteral nutrition (ED-9) was as effective as Elental on postoperative nutrition in rats.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810311-121991体表面電位図による心肥大の病態の推定と鑑別診断―特に肥大型心筋症と高血圧性肥大心の鑑別診断を中心に―11931205ENKatashiMatsubaraThe present study was conducted to clarify electrophysiological characteristics of left ventricular hypertrophy (LVH) and to discriminate hypertrophic cardiomyopathy (HCM) from hypertension-induced LVH with body surface mapping. QRS area map, QRST area map and VAT map of body surface mapping were recorded on 37 patients with HCM, 37 with essential hypertension (EH) and 21 with aortic regurgitation (AR) using Yamada's method. HCM, EH and AR showed similar patterns of QRS area map. However, the maximum points of QRST area map located at the midsternal line (E5) in HCM, and positioned on the left midclavicular line (G4) in EH and AR. The minimum point of the QRST area map appeared at the left midclavicular line (G3) where the maximum point of the QRS area map was located. These findings indicate that the QRST area map would enable to differentiate HCM from EH and AR. With the VAT map, AR showed closed isochrone lines on the left precordium, which indicated delayed ventricular activation in this region. Statistical analysis revealed that the value of the maximum point of the QRST area (Max. QRST) and the sum of values of the positive QRST area ( positive QRST area) differentiates HCM from EH. When the Max. QRST was 0.6μVs or less and the positive QRST area was 14μVs or less, the diagnostic accuracy of HCM could be made more than 70%. These findings suggested that the diagnostic criteria derived from the QRST area map is of use to distinguish HCM from hypertension-induced LVH.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991特発性血小板減少性紫斑病 (ITP)に関する臨床的研究 第2編 ITP の治療効果の解析とステロイド難反応性ITPに対するコルヒチン療法の意義について373386ENNaokazuTsurumiClinical effects of steroid and colchicine therapy in 49 patients with ITP especially the refractory cases were evaluated in comparison with splenectomy and danazol therapy.
There were 27(55%) steroid resistant patients who could not maintain platelet counts of 5×10(4)/μl with prednisolone doses of less than 10mg/day. Among the 16 steroid resistant patients treated with colchicine, there were 3 patients with complete remission and 3 others who had good to excellent response, that is, 6(37.5%) improved overall. This therapy was more effective than splenectomy (33.3%) and danazol (25%). Colchicine was did not effective in patients who did not respond to prednisolone, but was useful when patients showed at least a transient rise of the platelet count with prednisolone. In many cases, a response to colchicine was seen after a month, and in the patients who failed to show a rise in the platelet count after 2 months of colchicine therapy, no benefit was seen even when the therapy was continued. Colchicine is advantageous in the treatment of the steroid resistant ITP over the immunosuppressive agents or high-dose γ-globulin that are expensive and produce only a transient rise in the platelet count.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990損傷の法医学的考察―司法解剖13例について―2336ENRyoNanikawaYoshiakiHashimotoFumioMoriyaSatoruMiyaishiMiyokoNakaiXuYangChun GangGuoIn this paper we present 13 autopsy cases on interest in medico-legal traumatology. The cases are as follows : 1)two cases of incomplete cardiac rupture dur to thoracic trauma, 2)rupture of herniated large intestine due to abdominal trauma, 3)large incised wounds on the side of the neck by a small kitchen knife, 4)a homicidal case with similar wounds that accompanied self-inflicted wounds, 5)a homicidal case accompanied by multiple stab wounds on the chest, 6)an accidental death skewered by a slender metallic stick, 7)special fatal shotgun injuries, 8)a homicidal case accompanid by various burns by an electric hair-dryer, iron and ciga-rettes, 9)two murder cases by a metallic baseball bat, 10)a suicidal case due to a fall from a high place, and 11)a severely disrupted victim of a road traffic accident.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990腸閉塞を初発症状とする非特異性多発性小腸潰瘍の一例―本邦報告95例の検討―16ENHiromiIwagakiShoYunokiYasuhikoHiguchiSadanoriFuchimotoKunzoOritaYasushiHorieNon-specific multiple ulcers of the small intestine is one of the new disease entities, differing from Crohn's disease and simple ulcers of the small intestine. The clinical course of this disease ia still poorly understood, and the factors which inflence the progression or healing of these lesions remain unknown. We reviewed 95 cases of non-specific multiple ulcers of the small intestine in the Japanese literature. Non-specific multiple ulcers were seen primarily in young adults, although our patient was a 73 year-old female. The main symptoms of this disease included occult blood in the stool, anemia, hypoproteinemia, abdominal pain and ileus. Our case was accompanied by ileus at the onset without anemia and hypoproteinemia. Almost all of the patients have a clinical course of long duration. Macroscopic examinations in this disease are characterized by multipe shallow ulcers (UL-I-II) developing crosswise or obliquely on the intestinal mucosa and several areas of stenosis. No cases of perforation, fisula fornation, obstruction or abscess were noted. The recurrence rate was 26.3%.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991心筋虚血・再灌流障害における過酸化脂質の動態と h-SOD 投与効果293303ENEijiIkedaTo clarify the role of free radicals and the efficacy of human superoxide dismutase (h-SOD) on cardiac ischemia/reperfusion injury, adult mongrel dogs were placed on a cardiopulmonary bypass (CPB). Aorta was cross clamped for 120 minutes and crystalloid cardioplegic solution was administered into the aortic root every 30 minutes. Sixteen dogs were divided into the control group and non cross clamped group (XCL(-)group). They were placed on total CPB for 130 minutes without an aortic cross clamp.
The control group showed higher thiobarbituric acid reactive substance (TBARS) release from heart in early reperfusion phase (P<0.05), and suppressed recovery of cardiac index (CI) and max dp/dt at 60 minutes after reperfusion (P<0.01 and P<0.05, respectively) than XCL (-) group. Eight dogs were administered saline and 32 dogs were administered saline and h-SOD into the aortic root just before reperfusion. Dogs, administered h-SOD, were devided into four groups by the dese of h-SOD, group I : 1mg/kg, group II : 3mg/kg, group III : 10mg/kg, and group IV : 20mg/kg. Between control and saline groups, no significant difference was found. Groups I and II showed suppressed TBARS release from the heart in the early reperfusion phase than the control group (P<0.01 and P<0.05, respectively). Groups II and III showed higher recovery of CI at 60 minutes after reperfusion than the control group (P<0.01 and P<0.05, respectively). In conclusion, significantly higher TBARS was released from the heart and recovery of cardiac function was suppressed in cardiac ischemia/reperfusion injury. The h-SOD administtation was effective to protect the heart from cardiac ischemia/reperfusion injury.No potential conflict of interest relevant to this article was reported.岡山大学埋蔵文化財調査研究センターActa Medica Okayama20072008岡山大学埋蔵文化財調査研究センター紀要2007188ENTakahiroNozakiJunMitsumotoShihoIwasakiEtsuyoYamamotoSusumuIkeda第１章 津島岡大遺跡の調査研究
第２章 鹿田遺跡の調査研究
第３章 構内遺跡の調査研究
第４章 調査資料の整理・研究および公開・活用
第５章 2007年度における調査・研究のまとめ
付 編No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581039-101991大腸 pm 癌の臨床病理学的検討10811088ENHiromiIwagakiAkioHizutaNagahideMatsubaraShigeoShiikiFumihiroHamadaAkiraGouchiYasuakiKamikawaKunzoOritaSadanoriFuchimotoKoichiMizobuchiDuring the 13 years from 1978 to 1990, 50 cases of colorectal cancer, infiltrating to the proper muscle layer, were experienced, and were evaluated on the basis of clinicopathological findings. Pm colorectal carcinoma were classified into two groups (pm1,pm2) according to the depth of invasion into the proper muscle layer. Most of the pm colorectal carcinomas were located in the rectum (64%). According to macroscopic classification, the ulcerative type occurred more often (84%) than the elevated type (16%). As the carcinoma invaded deeper into the proper muscle layer, the incidence of lymphatic vessel invasion tended to become higher. Lymphnode metastasis from the ulcerative type cancer (26.2%) was less frequent than that of the elevated type (62.5%). Lymphnode metastasis from the elevated type cancer was confined to the n2 lymphnode. On the other hand, lymphnode metastasis from the ulcerative type had invaded to the n3 lymphnode. These findings indicated that R3 operation is needed for pm colorectal cancer of both the elevated and the ulcerative type, although nerve preserving operation or selective lateral lymphnode dissection is reasonable for pm rectal cancer.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581039-101991大腸癌他臓器浸潤症例の検討10751079ENShigeoShiikiSadanoriFuchimotoHiromiIwagakiFumihiroHamadaAkioHizutaKunzoOritaThe clinicopathologic features of 39 cases of colorectal cancer with invasion to the adjacent organs (si,ai) were studied. Twenty seven were cases with combined resection of involved organs. Twenty two and 17 cases were located in colon and rectum, respectively. The D region was mostly involved, followed by, the C and T region. Five cases had invasion to the gastrointestinal tract, 2 cases had invasion to the liver, gall bladder or pancreas. Twenty one cases had urogenital organ invasion and 11 cases had invasion to sacrum and other organs. The survival rate of cases with combined resection of the involved organs was significantly high compared with non-resection. Also, the survival rate of curative resection was significantly high compared with non-curative resection. Aggressive resection of involved organs seems to be important for good prognosis.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810411-121992Neuro-Behçet 病における大脳皮質,皮質下白質の病変11451158ENMasakazuOhbayashiFoci of tissue sponginess and necrosis in the cerebral cortex and the subcortical white matter were studied histopathologically in three cases of Neuro-Behçet's disease. The following results were obtained: Lesions in the cerebral cortex and the subcortical white matter were less severe than those in the brain stem. Though recent and older foci coexisted, glial scar foci were rare. Necrotic foci in the cerebral cortex and the subcortical white matter were vascular in origin. Foci were more numerous in the cerebral cortex than in the subcortical white matter. Foci were relatively numerous in the temporal lobe, especially in the hippocampus (Case 2), and were not so numerous in the frontal lobe. Mental symptoms such as hypospontaneity, blunted affect, euphoria, distrubance of immediate and recent memory, forced laughing and crying and bradyphrenia are attributable to brain stem lesions, but some cases of Neuro-Behçet's disease with numerous necrotic foci in the hippocampus and adjacent structures are believed to have hippocampal amnesia superimosed on brain stem symptoms.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810411-121992h-SOD による心筋虚血後再灌流障害抑制効果についての臨床的検討11271134ENKoujiTakataIn valve replacement surgery, human superoxide dismutase (h-SOD) was administered just before reperfusion, and the effect of h-SOD on reperfusion injury was studied. Release of cardiac enzymes (CPK-MB and HBD), increase of left ventricular volume, and recovery rate of cardiac function were measured. The release of the enzymes during 60 minutes after reperfusion in the group receiving h-SOD (3mg/kg) was less than that of the control (without h-SOD)group (p<0.01). Myocardial edema (volume increase) was also reduced by h-SOD (1mg/kg or 3mg/kg : p<0.01). Recovery of cardiac function after reperfusion of the h-SOD group was better than that of the control group. In conclusion, h-SOD can protect the myocardium from reperfusion injury and accelerate the rate of recovery of cardiac function after global ischemia.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810411-121992Tl-201心筋シンチグラフィーを用いた心臓弁膜症における心筋性状及び心予備能の評価10591068ENShunjuIndoThis study was performed to clarify whether the extent-score (Ex-Score) calculated by Tl-201 myocardial scintigraphy is a reliable indicator of the severity of myocardial damage and cardiac residual capacity in valvular heart diseases. The subjects consisted of 38 patients (10 with aortic regurgitation (AR), 4 with aortic stenosis (AS), 13 with mitral regurgitation (MR) and 11 with mitral stenosis (MS)). Ex-Score were significantly correlated with the severity of myocardial damage found in biopsied specimens obtained intraoperatively (correlation efficiency to Ex-Score with cell diameter in AR, % fibrosis in AR, cell diameter in AS, electron microscopic score in MR and % fibrosis in MS was 0.873, 0.734, 0.970, 0.913 and 0.659, respectively). Ex-Score were also correlated with cardiac residual capacity determined by radioisotope angiography (correlation efficiency to Ex-Score with % ejection fraction in AR, % end-systolic volume in MR, % end-diastolic volume in MS was -0.764, 0.790 and -0.763, respectively). These results suggest that the severity of myocardial damage and cardiac residual capacity can be estimated by Tl-201 myocardial scintigraphy (Ex-Score) in valvular heart diseases.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581049-101992乳癌サーモグラフｨ所見と予後の検討;サーモグラフｨにおける温度上昇と血管構築の変化931941ENMasakazuMurakamiThe thermographic findings of 191 patients with Satges I-III breast cancer were retrospectively evaluated to determine the prognostic indicators of disease-free survival in both the whole study population and in each histological stage. The angioarchitecture of 75 breast cancer specimens was subsequently examined morphometrically using an immunohistochemical method, and was then compared with the extent of increase in the temperature at the tumor site. The extent of increase in the temperature was more closely related to the prognosis than was the thermal pattern. In stage II cancer (n=57), patients with lesions that showed a temperature increase > 1.5℃ had a poorer prognosis than the patients with hypothermic regions. (p<0.05). The range of skin temperature elevation at the tumor site correlated with the vascular changes in the skin above the tumor rather than with changes within or around the tumor in all of the patients. The increase in temperature above a tumor was concluded to be useful for assessing the prognosis and the grade of malignancy of breast cancer. The skin blood flow was also suggested to have the closest relationship with thermographic findings and the extent of the increase in blood flow to be a prognostic indicator for breast cancer.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581041-21992サルコイドーシスの肺肉芽腫形成に対する Propionibacterium acens の関与に関する研究 第1編 サルコイドーシス肺胞リンパ球のPropionibacterium acens に対する Interleukin-2 産生及び Interleukin-2 受容体発現のついて117127ENYoshihiroMoriWe previously reported that alveolar lymophocytes in patients with active sarcoidosis are sensitized Propionibacterium acnes (P. acnes) which may play a significant role in the induction of alveolitis in these patients. We further investigated the production of Interleukin-2 (IL-2), and the responsiveness to IL-2 of alveolar lymphocytes obtained from sarcoidosis patients and stimulated by P. acnes in vitro. In 21 untreated sarcoidosis patients, 7 treated patients and 13 control subjects, the mean IL-2 activity of fluid released from cultured alveoloar lymphocytes was 9.8±15.7 (M±SD), 1.9±4.7 and 0.2±0.8 u/ml respectively. The IL-2 activity of lymphocytes from untreated patients was significantly higher than that of control subjects (p<0.02). Neither perioheral lymphocytes in sarcoidosis patients nor in controls produced IL-2 stimulated by P. acnes. The responsiveness of alveloar lymphocytes to recombinant IL-2 was evaluated by 3H-thymidine uptake in the presence and absence of P. acnes. Lymphocytes stimulated by P. acnes showed a significantly increased uptake (3,766±3,929 dpm) compred to ustimulated lymphocytes (1,123±968 dpm) obtained from 11 untreated sarcoidosis patients (p<0.02). On the other hand, the responsiveness of lymphocytes obtained from 6 control subjects was low regardless of stimulation by P. acnes. There was a significant correlation (p<0.05) between the P. acnes-induced production of IL-2 by alveolar lymphocytes and the blastogenesis of alveloar lymphocytes in untreated sarcoidosis patietnes. Our findings indicate that P. acnes stimulated IL-2 production and IL-2 receptor induction in alveolar lymphocytes from patients with active sarcoidosis. This study supported our hypothesis that P. acnes could be an antigen causing sarcoidosis.No potential conflict of interest relevant to this article was reported.