Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Necrotizing Fasciitis Caused by ESBL-Producing Raoultella ornithinolytica in an Immunocompromised Patient with VEXAS Syndrome141145ENMoeSakamoto-TokunagaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasakiMatobaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokazuTamuraDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNatsukiKubotaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuyaTerajimaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaShidaharaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiHiroseDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShoichiNawachiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakatoNakadoiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiaMiyawakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEriKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoTakano-NarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShumaTsujiDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityKazuyoshiGotohDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/70456VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory somatic) syndrome has a poor prognosis, with infections being a major cause of death. Raoultella ornithinolytica is an environmental bacterium found predominantly in soil and water. Although R. ornithinolytica can cause various infections, necrotizing fasciitis due to this bacterium has not been reported. We describe the case of an 84-year-old Japanese male with VEXAS syndrome who developed septic shock and necrotizing fasciitis while he was under immunosuppressive therapy. The pathogen was initially misidentified as R. planticola by mass spectrometry but later confirmed by whole-genome sequencing as extended spectrum β-lactamase (ESBL) produced by R. ornithinolytica. Although a life-saving leg amputation was required, the patient recovered with appropriate antibiotic therapy. R. ornithinolytica is thus able to cause severe skin infections in immunocompromised individuals.No potential conflict of interest relevant to this article was reported.Beck DB, Ferrada MA, Sikora KA, Ombrello AK, Collins JC, Pei W, Balanda N, Ross DL, Ospina Cardona D, Wu Z, Patel B, Manthiram K, Groarke EM, Gutierrez-Rodrigues F, Hoffmann P, Rosenzweig S, Nakabo S, Dillon LW, Hourigan CS, Tsai WL, Gupta S, Carmona-Rivera C, Asmar AJ, Xu L, Oda H, Goodspeed W, Barron KS, Nehrebecky M, Jones A, Laird RS, Deuitch N, Rowczenio D, Rominger E, Wells KV, Lee CR, Wang W, Trick M, Mullikin J, Wigerblad G, Brooks S, DellʼOrso S, Deng Z, Chae JJ, Dulau-Florea A, Malicdan MCV, Novacic D, Colbert RA, Kaplan MJ, Gadina M, Savic S, Lachmann HJ, Abu-Asab M, Solomon BD, Retterer K, Gahl WA, Burgess SM, Aksentijevich I, Young NS, Calvo KR, Werner A, Kastner DL and Grayson PC: Somatic Mutations in UBA1 and Severe Adult-Onset Autoinflammatory Disease. N Engl J Med (2020) 383: 2628-2638.Georgin-Lavialle S, Terrier B, Guedon AF, Heiblig M, Comont T, Lazaro E, Lacombe V, Terriou L, Ardois S, Bouaziz JD, Mathian A, Le Guenno G, Aouba A, Outh R, Meyer A, Roux-Sauvat M, Ebbo M, Zhao LP, Bigot A, Jamilloux Y, Guillotin V, Flamarion E, Henneton P, Vial G, Jachiet V, Rossignol J, Vinzio S, Weitten T, Vinit J, Deligny C, Humbert S, Samson M, Magy-Bertrand N, Moulinet T, Bourguiba R, Hanslik T, Bachmeyer C, Sebert M, Kostine M, Bienvenu B, Biscay P, Liozon E, Sailler L, Chasset F, Audemard-Verger A, Duroyon E, Sarrabay G, Borlot F, Dieval C, Cluzeau T, Marianetti P, Lobbes H, Boursier G, Gerfaud-Valentin M, Jeannel J, Servettaz A, Audia S, Larue M, Henriot B, Faucher B, Graveleau J, de Sainte Marie B, Galland J, Bouillet L, Arnaud C, Ades L, Carrat F, Hirsch P, Fenaux P, Fain O, Sujobert P, Kosmider O and Mekinian A: Further characterization of clinical and laboratory features in VEXAS syndrome: large-scale analysis of a multicentre case series of 116 French patients. Br J Dermatol (2022) 186: 564-574.de Valence B, Delaune M, Nguyen Y, Jachiet V, Heiblig M, Jean A, Riescher Tuczkiewicz S, Henneton P, Guilpain P, Schleinitz N, Le Guenno G, Lobbes H, Lacombe V, Ardois S, Lazaro E, Langlois V, Outh R, Vinit J, Martellosio JP, Decker P, Moulinet T, Dieudonne Y, Bigot A, Terriou L, Vlakos A, de Maleprade B, Denis G, Broner J, Kostine M, Humbert S, Lifermann F, Samson M, Pechuzal S, Aouba A, Kosmider O, Dion J, Grosleron S, Bourguiba R, Terrier B, Georgin-Lavialle S, Fain O, Mekinian A, Morgand M, Comont T, Hadjadj J and French VG: Serious infections in patients with VEXAS syndrome: data from the French VEXAS registry. Ann Rheum Dis (2024) 83: 372-381.Drancourt M, Bollet C, Carta A and Rousselier P: Phylogenetic analyses of Klebsiella species delineate Klebsiella and Raoultella gen. nov., with description of Raoultella ornithinolytica comb. nov., Raoultella terrigena comb. nov. and Raoultella planticola comb. nov. Int J Syst Evol Microbiol (2001) 51: 925-932.Huang Q, Zhang J and Liao G: Abdominal abscess caused by Raoultella ornithinolytica secondary to postoperative gastric fistula: case report and review of literature. BMC Infect Dis (2024) 24: 363.Goodman DT, Murphy D and Dorairaj J: Case Study: Soft tissue infection with Raoultella ornithinolytica. JPRAS Open (2022) 33: 17-20.Shimizu T, Ide H, Tsuji Y, Koga T and Kawakami A: VEXAS syndrome complicated with severe infection. Rheumatology (Oxford) (2022) 61: e374-e376.Yoshida A, Ota T, Sasaoka S, Matsuura H, Fujimoto W and Morita Y; Necrotizing fasciitis in a patient with rheumatoid arthritis treated with tocilizumab: Mod Rheumatol (2012) 22: 317-318.van de Sande MG and van Slobbe-Bijlsma ER: Necrotizing fasciitis in a rheumatoid arthritis patient treated with tocilizumab. Rheumatology (Oxford) (2012) 51: 577-578.Seng P, Boushab BM, Romain F, Gouriet F, Bruder N, Martin C, Paganelli F, Bernit E, Le Treut YP, Thomas P, Papazian L, Raoult D and Stein A: Emerging role of Raoultella ornithinolytica in human infections: a series of cases and review of the literature. Int J Infect Dis (2016) 45: 65-71.Sekowska A, Dylewska K, Gospodarek E and Bogiel T: Catheter-related blood stream infection caused by Raoultella ornithinolytica. Folia Microbiol (Praha) (2015) 60: 493-495.Van Cleve JR, Boucher BA, Smith DV and Croce MA: Ventilator associated pneumonia caused by Raoultella ornithinolytica in two immunocompetent trauma patients. Respir Med Case Rep (2018) 24: 135-137.Wang S, Xu L, Chi X, Li Y, Kou Z, Hou P, Xie H, Bi Z and Zheng B: Emergence of NDM-1- and CTX-M-3-Producing Raoultella ornithinolytica in Human Gut Microbiota. 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J Med Microbiol (2020) 69: 233-238.BMJActa Medica Okayama2056-59331212026Dental infection is associated with early relapse in patients with ANCA-associated vasculitise006392ENShoichiNawachiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiaMiyawakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMoeSakamoto-TokunagaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNatsukiKubotaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuyaTerajimaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyaMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiHiroseDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakatoNakadoiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesManamiHirata-WatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEriKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoTakano-NarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShigetomoTsujiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesObjectives Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a systemic autoimmune disease where infections can trigger relapses. Dental infections, being common and associated with systemic inflammation, may play a role in AAV relapse, though their impact remains unclear. We aimed to evaluate the association between severe dental infections and early relapse in patients with AAV.<br>
Methods This retrospective cohort study included patients newly diagnosed with AAV between January 2011 and July 2022. Patients with severe dental infections requiring tooth extraction were placed in the dental infection group, while the remaining patients were assigned to the control group. The primary outcome was defined as either vasculitis relapse or all-cause mortality within 1 year of treatment initiation. Adjusted HRs (aHRs) and 95% CIs were estimated using Cox proportional hazards models.<br>
Results A total of 93 patients were enrolled with a median age of 74 years. 41 patients (44.1%) had severe dental infections in this cohort. Over the 1-year follow-up period, 13 patients experienced a relapse and two died, resulting in a composite event rate of 20.9 per 100 person-years. Dental infection was independently associated with the composite outcome (aHR, 3.78 (95% CI 1.13 to 12.66); p=0.031). Exploratory analysis indicated that composite outcome rates were similar regardless of tooth extraction among patients with dental infections.<br>
Conclusions Severe dental infections were associated with increased risk of early relapse or mortality in AAV. These findings highlight the importance of early dental evaluation in AAV management.No potential conflict of interest relevant to this article was reported.Fuji Technology Press Ltd.Acta Medica Okayama1883-80302042025High-Definition Topographic Archiving and Educational Applications in Regions Affected by the 2024 Noto Peninsula Earthquake401409ENTakuroOguraGraduate School of Education, Hyogo University of Teacher EducationHiroyukiYamauchiArt Research Center, Ritsumeikan UniversityTatsutoAokiFaculty of Regional Development Studies, Kanazawa UniversityNobuhisaMattaGraduate School of Education, Okayama UniversityKotaroIizukaCenter for Spatial Information Science, The University of TokyoYoshiyaIwasaFaculty of Education, University of Teacher Education FukuokaTakayukiTakahashiInternational Research Institute of Disaster Science, Tohoku UniversityKiyomiHayashiFaculty of Regional Development Studies, Kanazawa UniversityTsuyoshiHattanjiInstitute of Life and Environmental Sciences, University of TsukubaTakashiOguchiCenter for Spatial Information Science, The University of TokyoThe 2024 Noto Peninsula earthquake (Mw 7.5) caused extensive damage in Ishikawa Prefecture, Japan, and surrounding areas, with considerable coastal uplift and tsunami flooding. Past 100 years’ records show no earthquake above Mw 7.0 in the Noto Peninsula, so for everyone alive today, this event is truly without precedent. Therefore, we aimed to support disaster prevention education by developing teaching materials using unmanned aerial vehicles (UAVs) based on digitally archived topographic changes. High-definition topographic data collected from multiple UAV surveys were processed into digital and analog formats, including 3D models, spherical panorama images, and 3D printings. These materials were designed to provide detailed and intuitive representations of post-disaster landforms and were used as educational tools in schools. The learning materials were introduced during a workshop for disaster-affected teachers, featuring hands-on activities to help participants familiarize themselves with the materials, and explore their integration into geography and science classes. Feedback from participants indicated that these tools were highly effective in enhancing classroom learning. The results of this study are expected to contribute to preserving disaster records while enhancing disaster awareness in educational settings and local communities.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7932025Immunometabolic Regulation of Innate Immunity in Systemic Lupus Erythematosus147155ENHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/68722Pathogens or their components can induce long-lasting changes in the behavior of innate immune cells, a process analogous to “training” for future threats or environmental adaptation. However, such training can sometimes have unintended consequences, such as the development of autoimmunity. Systemic lupus erythematosus (SLE) is a chronic and heterogeneous autoimmune disease characterized by the production of autoantibodies and progressive organ damage. Innate immunity plays a central role in its pathogenesis, contributing through impaired clearance of apoptotic cells, excessive type I interferon production, and dysregulated formation of neutrophil extracellular traps. Recent studies have revealed that metabolites and nucleic acids derived from mitochondria, a crucial energy production site, directly regulate type I interferon and anti-inflammatory cytokine production. These insights have fueled interest in targeting metabolic pathways as a novel therapeutic approach for SLE, offering promise for improving long-term patient outcomes.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832642025古松崇志著『ユーラシア東方の多極共存時代』287293ENKenyaWATANABE書評 (Book Review)10.18926/67964No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813632024令和５年度岡山医学会賞 総合研究奨励賞（結城賞）9193ENHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832632024渡辺信一郎著『中国古代国家論』308314ENFuminoriTSUCHIGUCHI書評 (Book Review)10.18926/66202No potential conflict of interest relevant to this article was reported.Public Library ScienceActa Medica Okayama1932-62031762022Real-world data on vitamin D supplementation and its impacts in systemic lupus erythematosus: Cross-sectional analysis of a lupus registry of nationwide institutions (LUNA)e0270569ENKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeAsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeijiOhashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMichikoMorishitaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiaMiyawakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoNarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuyukiYajimaDepartment of Medicine, Division of Rheumatology, Showa University School of MedicineRyusukeYoshimiDepartment of Stem Cell and Immune Regulation, Yokohama City University Graduate School of MedicineYasuhiroShimojimaDepartment of Medicine (Neurology and Rheumatology), Shinshu University School of MedicineShigeruOhnoCenter for Rheumatic Diseases, Yokohama City University Medical CenterHiroshiKajiyamaDepartment of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical UniversityKunihiroIchinoseDepartment of Immunology and Rheumatology, Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical SciencesShuzoSatoDepartment of Rheumatology, Fukushima Medical University School of MedicineMichioFujiwaraDepartment of Rheumatology, Yokohama Rosai HospitalJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground Although vitamin D concentration is reportedly associated with the pathogenesis and pathology of systemic lupus erythematosus (SLE), benefits of vitamin D supplementation in SLE patients have not been elucidated, to our knowledge. We investigated the clinical impacts of vitamin D supplementation in SLE. Methods A cross-sectional analysis was performed using data from a lupus registry of nationwide institutions. We evaluated vitamin D supplementation status associated with diseaserelated Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) as a parameter of long-term disease activity control. Results Of the enrolled 870 patients (mean age: 45 years, mean disease duration: 153 months), 426 (49%) received vitamin D supplementation. Patients with vitamin D supplementation were younger (43.2 vs 47.5 years, P < 0.0001), received higher doses of prednisolone (7.6 vs 6.8 mg/day, P= 0.002), and showed higher estimated glomerular filtration rates (79.3 vs 75.3 mL/min/1.73m(2), P= 0.02) than those without supplementation. Disease-related SDI (0.73 +/- 1.12 vs 0.73 +/- 1.10, P = 0.75), total SDI, and SLE Disease Activity Index (SLEDAI) did not significantly differ between patients receiving and not receiving vitamin D supplementation. Even after excluding 136 patients who were highly recommended vitamin D supplementation (with age >= 75 years, history of bone fracture or avascular necrosis, denosumab use, and end-stage renal failure), disease-related SDI, total SDI, and SLEDAI did not significantly differ between the two groups. Conclusions Even with a possible Vitamin D deficiency and a high risk of bone fractures in SLE patients, only half of our cohort received its supplementation. The effect of vitamin D supplementation for disease activity control was not observed.No potential conflict of interest relevant to this article was reported.Japanese Society of Internal MedicineActa Medica Okayama0918-29186072021Acute Kidney Injury Caused by Evans Syndrome with Systemic Lupus Erythematosus and Systemic Sclerosis10551060ENNatsumiMatsuokaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesNaokoKurookaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSumariKatoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesChikaHigashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKatsuyukiTanabeDivision of Hemodialysis and Apheresis, Okayama University HospitalMasaruKinomuraDivision of Hemodialysis and Apheresis, Okayama University HospitalNobuharuFujiiDepartment of Transfusion Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHitoshiSugiyamaDepartment of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesA 65-year-old woman with systemic sclerosis and systemic lupus erythematosus developed acute kidney injury (AKI), Coombs-positive autoimmune hemolytic anemia and autoimmune thrombocytopenia; therefore, she was diagnosed with Evans syndrome (ES). Intravascular hemolysis was suggested as the cause of AKI based on the presence of acute tubular injury and trace hemosiderin deposits on the renal biopsy. The renal function, hemolytic anemia and thrombocytopenia were restored by an increased dose of glucocorticoids, hemodialysis, and plasma exchange. Although ES with severe hemolytic anemia is very rare, it is important to detect possible renal dysfunction when encountering patients with severe hemolysis.No potential conflict of interest relevant to this article was reported.Nature ResearchActa Medica Okayama2045-23221112021Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysisENHarukiWatanabeGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKen-eiSadaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasayoshiHarigaiDepartment of Rheumatology, Tokyo Women’s Medical University School of MedicineKoichiAmanoDepartment of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical UniversityHiroakiDobashiDivision of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa UniversityYoshinariTakasakiDepartment of Internal Medicine and Rheumatology, Juntendo University School of MedicineShouichiFujimotoDepartment of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of MiyazakiTatsuyaAtsumiDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityKunihiroYamagataDepartment of Nephrology, Faculty of Medicine, University of TsukubaSakaeHommaDepartment of Advanced and Integrated Interstitial Lung Diseases Research, School of Medicine, Toho UniversityYoshihiroArimuraDepartment of Nephrology and Rheumatology, Kyorin University School of MedicineHirofumiMakinoOkayama UniversityResearch Committee of Intractable Vasculitis Syndrome (JPVAS) & Research Committee of Intractable Renal Disease of the Ministry of Health, Labour, and Welfare of JapanA novel patient cluster in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) may be identified in Japan. We performed multiple correspondence and cluster analysis regarding 427 clinically diagnosed AAV patients excluding eosinophilic granulomatosis with polyangiitis. Model 1 included the ANCA phenotype, items of the Birmingham Vasculitis Activity Score, and interstitial lung disease; model 2 included serum creatinine (s-Cr) and C-reactive protein (CRP) levels with model 1 components. In seven clusters determined in model 1, the ANCA-negative (n=8) and proteinase 3-ANCA-positive (n=41) groups emerged as two distinct clusters. The other five myeloperoxidase-ANCA-positive clusters were characterized by ear, nose, and throat (ENT) (n=47); cutaneous (n=36); renal (n=256), non-renal (n=33); and both ENT and cutaneous symptoms (n=6). Four clusters in model 2 were characterized by myeloperoxidase-ANCA negativity (n=42), without s-Cr elevation (<1.3 mg/dL) (n=157), s-Cr elevation (<greater than or equal to>1.3 mg/dL) with high CRP (>10 mg/dL) (n=71), or s-Cr elevation (>= 1.3 mg/dL) without high CRP (<= 10 mg/dL) (n=157). Overall, renal, and relapse-free survival rates were significantly different across the four clusters in model 2. ENT, cutaneous, and renal symptoms may be useful in characterization of Japanese AAV patients with myeloperoxidase-ANCA. The combination of s-Cr and CRP levels may be predictive of prognosis.No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1478-63542312021Association of glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS): a cross-sectional studyENYoshiaMiyawakiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySayakaShimizuInstitute for Health Outcome & Process Evaluation Research (i-Hope International)YusukeOgawaDepartment of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto UniversityKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukitoshiKatayamaUshimado Marine Institute, Faculty of Science, Okayama UniversityYosukeAsanoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYurikoYamamuraGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySumieHiramatsu-AsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeijiOhashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMichikoMorishitaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMarikoTakano-NarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNobuyukiYajimaDepartment of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto UniversityRyusukeYoshimiDepartment of Stem Cell and Immune Regulation, Yokohama City University Graduate School of MedicineYasuhiroShimojimaDepartment of Medicine (Neurology and Rheumatology), Shinshu University School of MedicineShigeruOhnoCenter for Rheumatic Diseases, Yokohama City University Medical CenterHiroshiKajiyamaDepartment of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical UniversityKunihiroIchinoseDepartment of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical SciencesShuzoSatoDepartment of Rheumatology, Fukushima Medical University School of MedicineMichioFujiwaraDepartment of Rheumatology, Yokohama Rosai HospitalHajimeYamazakiSection of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto UniversityYosukeYamamotoDepartment of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto UniversityJunWadaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityShunichiFukuharaSection of Clinical Epidemiology, Department of Community Medicine, Graduate School of Medicine, Kyoto UniversityBackground While survival of systemic lupus erythematosus (SLE) patients has improved substantially, problems remain in the management of their emotional health. Medium to high-dose glucocorticoid doses are known to worsen emotional health; the effect is unclear among patients receiving relatively low-dose glucocorticoids. This study aims to investigate the association between low glucocorticoid doses and emotional health in lupus low disease activity state (LLDAS). Methods This cross-sectional study drew on data from SLE patients in 10 Japanese institutions. The participants were adult patients with SLE duration of >= 1 year who met LLDAS criteria at the study visit from April 2018 through September 2019. The exposure was the daily glucocorticoid dose (mg oral prednisolone). The outcome was the emotional health score of the lupus patient-reported outcome scale (range: 0 to 100). Multiple linear regression analysis was performed with adjustment for confounders including disease-related damage, activity, and psychotropic drug use. Results Of 192 patients enrolled, 175 were included in the analysis. Their characteristics were as follows: female, 89.7%; median age, 47 years (interquartile range (IQR): 37.0, 61.0). Median glucocorticoid dose was 4.0 mg (IQR 2.0, 5.0), and median emotional health score 79.2 (IQR 58.3, 91.7). Multiple linear regression analysis showed daily glucocorticoid doses to be associated with worse emotional health (beta coefficient = - 2.54 [95% confidence interval - 4.48 to - 0.60], P = 0.01). Conclusions Daily glucocorticoid doses were inversely associated with emotional health among SLE patients in LLDAS. Further studies are needed to determine whether glucocorticoid tapering leads to clinically significant improvements in emotional health.No potential conflict of interest relevant to this article was reported.Lippincott, Williams & WilkinsActa Medica Okayama0025-797410032021Granulomatosis with polyangiitis with obstructive pneumonia progressing to hypertrophic pachymeningitis A case reporte24028ENKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYurikoYamamuraDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeAsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukitoshiKatayamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSumieHiramatsu-AsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeijiOhashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMichikoMorishitaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoNarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRationale: </br>
Bronchial involvement alone is a rare initial manifestation of granulomatosis with polyangiitis (GPA). Herein, we report a case of refractory GPA with obstructive pneumonia caused by bronchial involvement.</br>
Patient concerns: </br>
A 65-year-old man complained of a 2-week cough and fever.</br>
Diagnoses: </br>
Considering the presence of opacities and multiple consolidations in both lungs due to obstruction or stenosis on the bronchus, which did not respond to antibiotics, and proteinase-3-antineutrophil cytoplasmic autoantibody positivity, he was diagnosed with GPA. Positron emission tomography- computed tomography scan revealed no abnormal findings in the upper respiratory tract.</br>
Interventions: </br>
He was treated with prednisolone (PSL, 50 mg/d) and intravenous cyclophosphamide.</br>
Outcomes: </br>
His general and respiratory symptoms improved. However, 8 weeks after PSL treatment at 20 mg/d, he developed a relapse of vasculitis along with sinusitis and hypertrophic pachymeningitis. Hence, PSL treatment was resumed to 50 mg/d, and weekly administration of rituximab was initiated. Consequently, the symptoms gradually mitigated.</br>
Lessons: </br>
GPA with bronchial involvement is often intractable and requires careful follow-up, which should include upper respiratory tract and hypertrophic pachymeningitis assessment.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7512021Minimally Invasive Spinal Stabilization with Denosumab before Total Spondylectomy for a Collapsing Lower Lumbar Spinal Giant Cell Tumor95101ENKeitaroMinatoDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesToruHiranoDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesHiroyukiKawashimaDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesTetsuroYamagishiDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesKeigoWatanabeDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesMasayukiOhashiDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesAkiraOgoseDepartment of Orthopedic Surgery, Uonuma Kikan HospitalNaotoEndoDivision of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental SciencesCase Report10.18926/AMO/61442A 21-year-old man consulted our hospital for treatment of a spinal giant cell tumor (GCT) of Enneking stage III. Lower lumbar-spine tumors and severe spinal canal stenosis are associated with high risk for surgical mor-bidity. Stability was temporarily secured with a percutaneous pedicle screw fixation in combination with deno-sumab, which shrank the tumor. Total en bloc spondylectomy was then performed 6 months after initiation of denosumab, and the patient was followed for 3 years. There was no local recurrence, and bony fusion was obtained. Minimally invasive surgery and denosumab allowed safer and easier treatment of a collapsing lower lumbar extra-compartmental GCT.No potential conflict of interest relevant to this article was reported.Nature ResearchActa Medica Okayama2045-23221012020Risk of higher dose methotrexate for renal impairment in patients with rheumatoid arthritis18715ENKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeAsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSumie Hiramatsu AsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYurikoYamamuraDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeijiOhashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMichikoMorishitaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoNarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRenal impairment is a major concern in patients taking high-dose methotrexate (MTX) for malignancy, but it has not been fully explored in rheumatoid arthritis (RA) patients taking low-dose MTX. This study aimed to elucidate the dose-dependent effects of MTX on the renal function of patients with RA. We retrospectively reviewed 502 consecutive RA patients who were prescribed MTX for >= 1 year at Okayama University Hospital between 2006 and 2018. The primary outcome was the change in estimated glomerular filtration rate (eGFR) over 1 year. The association between MTX dosage (<8, 8-12, and >= 12 mg/week) and the change in eGFR was evaluated using multiple linear regression analysis with adjustment for possible confounding factors including age, sex, disease duration, body weight, comorbidity, baseline eGFR, concomitant treatment, and disease activity. Mean patient age was 63 years; 394 (78%) were female. Median disease duration was 77 months, while mean MTX dosage was 8.6 mg/week. The last 1-year change of eGFR (mean +/- SD) in patients treated with MTX<8 (n=186), 8-12 (n=219),>= 12 mg/week (n=97) decreased by 0.2 +/- 7.3, 0.6 +/- 8.6, and 4.5 +/- 7.9 mL/min/1.73 m(2)/year, respectively (p<0.0001). After adjustment for the confounding factors, MTX >= 12 mg/week was still correlated with a decrease in 1-year eGFR (beta-coefficient:-2.5; 95% confidence interval,-4.3 to-0.6; p=0.0089) in contrast to MTX 8-12 mg/week. Careful monitoring of renal function is required in patients with MTX >= 12 mg/week over the course of RA treatment regardless of disease duration.No potential conflict of interest relevant to this article was reported.岡山大学文学部国語国文学研究室Acta Medica Okayama0386-3123141986譬喩の要因――万葉集第八・一五〇〇番歌について――19EN10.18926/okadaironkou/60494No potential conflict of interest relevant to this article was reported.岡山大学文学部国語国文学研究室Acta Medica Okayama0386-3123191991万葉集の一回的素材816EN10.18926/okadaironkou/60379No potential conflict of interest relevant to this article was reported.岡山大学文学部国語国文学研究室Acta Medica Okayama0386-3123231995紫式部３２−３５番歌についての考察――「文散らし」をめぐって――1322EN10.18926/okadaironkou/60266No potential conflict of interest relevant to this article was reported.岡山大学文学部日本語日本文学研究室Acta Medica Okayama0386-3123302002後鳥羽院の『遠島御歌合』「忍恋」題歌について8291EN10.18926/okadaironkou/60169No potential conflict of interest relevant to this article was reported.岡山大学文学部言語国語国文学会Acta Medica Okayama0386-3123352007後鳥羽院『千五百番歌合』判歌の最終歌について2435EN10.18926/okadaironkou/60084No potential conflict of interest relevant to this article was reported.岡山大学言語国語国文学会Acta Medica Okayama0386-3123382010後鳥羽院の『千五百番歌合』百首歌について―同時代歌人からの影響を中心に―2841EN10.18926/okadaironkou/60055No potential conflict of interest relevant to this article was reported.岡山大学言語国語国文学会Acta Medica Okayama0386-3123392011後鳥羽院の『千五百番歌合』百首歌について 続考―同時代歌人からの摂取の意図―7082EN10.18926/okadaironkou/60050No potential conflict of interest relevant to this article was reported.岡山大学言語国語国文学会Acta Medica Okayama0386-3123412013後鳥羽院の『千五百番歌合』秋二・秋三判歌について 補遺―その制作時期・意図と建久期速詠歌からの影響―114EN10.18926/okadaironkou/60034No potential conflict of interest relevant to this article was reported.岡山大学言語国語国文学会Acta Medica Okayama0386-3123422014後鳥羽院の『千五百番歌合』秋二・秋三判歌について―その秀句志向と藤原定家からの影響―1527EN10.18926/okadaironkou/60028No potential conflict of interest relevant to this article was reported.岡山大学言語国語国文学会Acta Medica Okayama0386-3123432015『時代不同歌合』の歌人の選定について―その歌人的評価から―117EN10.18926/okadaironkou/60021No potential conflict of interest relevant to this article was reported.岡山大学言語国語国文学会Acta Medica Okayama0386-3123452017門脇重綾と和歌――その長歌の表現の特質――3850EN10.18926/okadaironkou/59998No potential conflict of interest relevant to this article was reported.BMCActa Medica Okayama1471-23692112020Association of explanatory histological findings and urinary protein and serum creatinine levels at renal biopsy in lupus nephritis: a cross-sectional study208ENEriKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiaMiyawakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeAsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYurikoYamamuraDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSumieHiramatsu-AsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMichikoMorishitaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeijiOhashiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoNarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism,Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground</br>
The aim of the present study was to evaluate the association between the histology of active and chronic lesions and urinary protein and serum creatinine (SCr) levels, as common clinical endpoints in clinical trials for lupus nephritis (LN).</br>
Methods</br>
In total, 119 patients diagnosed with LN class III, IV, and V, as defined by the International Society of Nephrology/Renal Pathology Society, between 1990 and 2015, were enrolled in the present study. Multiple regression analysis was performed to explore semi-quantitative histological variables associated with urinary protein and SCr levels.</br>
Results</br>
The mean age of the enrolled patients was 45 years, and 79% were female. The mean SCr and mean urinary protein levels at the time of renal biopsy were 0.87 mg/dl and 3.00 g/gCr, respectively. Class IV (71%) was the most common type of LN followed by class III (17%), and class V (13%). Multicollinearity was confirmed between monocellular infiltration (variance inflation factor [VIF] = 10.22) and interstitial fibrosis (VIF = 10.29), and between karyorrhexis (VIF = 4.14) and fibrinoid necrosis (VIF = 4.29). Fibrinoid necrosis and monocellular infiltration were subsequently excluded, and multiple regression analysis revealed that only the urinary protein level was correlated with wire loop lesions (β-coefficient [β]: 1.09 and confidence interval [CI]: 0.35 to 1.83), and that the SCr level was correlated with glomerular sclerosis (β: 1.08 and CI: 0.43 to 1.74).</br>
Conclusion</br>
As urinary protein and SCr levels were not quantitatively associated with active lesions, they may not accurately reflect the response to remission induction therapy in patients with LN.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7432020Risk Factors for Chronic Damage Accumulation Across Different Onset Eras in Systemic Lupus Erythematosus: A Cross-sectional Analysis of a Lupus Registry of Nationwide Institutions (LUNA)191198ENKeijiOhashiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeAsanoDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoHayashiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYurikoYamamuraDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSumie HiramatsuAsanoDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiaMiyawakiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMichikoMorishitaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEriKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNorikoTatebeDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoNarazakiDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsueSunahori-WatanabeDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoKawabataDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuyukiYajimaDivision of Rheumatology, Department of Medicine, Showa University School of MedicineJunWadaDepartment of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/59949Chronic damage accumulation affects not only mortality but also quality of life in patients with systemic lupus erythematosus (SLE). Risk factors for chronic damage were explored in SLE through different onset eras. Two hundred forty-five patients at Okayama University Hospital and Showa University Hospital were divided into three groups based on the onset era: a past-onset group (onset before 1995; n=83), middle-onset group (1996-2009; n=88), and recent-onset group (after 2010; n=74). The mean Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI) score as an index of chronic damage was 1.93, 1.24, and 0.53 in the past-, middle-, and recent-onset groups, respectively. In the pastonset group, the total SDI score was significantly associated with glucocorticoid monotherapy by linear regression analysis (β-coefficient [β]=0.63; 95% confidence interval [CI], 0.21-1.05) and C-reactive protein levels (β=0.67; 95% CI, 0.27-1.07). In the middle-onset group, the total SDI score was significantly associated with the SLE Disease Activity Index at registration (β=0.09; 95% CI, 0.03-0.12). Reducing the accumulation of chronic damage in SLE patients might be possible with the concomitant use of immunosuppressants and tight control of disease activity.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 Okayama352019鹿田遺跡13 ー第26次調査ー (医学部動物実験施設改修に伴う発掘調査)ENYujiYamaguchi Archaeological Research Center, Okayama UniversityKentaroMinamiArchaeological Research Center, Okayama UniversityShihoIwasakiArchaeological Research Center, Okayama UniversityYokoOkiNo potential conflict of interest relevant to this article was reported.Lippincott, Williams & WilkinsActa Medica Okayama1076-16082542019Cavernous Transformation and Granulomatous Epididymis in Behçet Disease4547ENYumiMotokuraDepartment of Nephrology, Rheumatology Endocrinology and Metabolism Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology Endocrinology and Metabolism Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesYurikoYamamuraDepartment of Nephrology, Rheumatology Endocrinology and Metabolism Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesYuzukiKanoDepartment of Nephrology, Rheumatology Endocrinology and Metabolism Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology Endocrinology and Metabolism Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesTomokoKawabataDepartment of Nephrology, Rheumatology Endocrinology and Metabolism Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesKen-eiSadaDepartment of Nephrology, Rheumatology Endocrinology and Metabolism Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology Endocrinology and Metabolism Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Nature Publishing GroupActa Medica Okayama2045-232292019Regulation of Cathepsin E gene expression by the transcription factor Kaiso in MRL/lpr mice derived CD4+T cells3054ENSumieHiramatsuDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsue S.WatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoniaZeggarDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYosukeAsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshiaMiyawakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYurikoYamamuraDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEriKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakayukiKatsuyamaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHarukiWatanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoTakano-NarazakiDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshinoriMatsumotoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoKawabataDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKen-EiSadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesGlobal DNA hypomethylation in CD4+ cells in systemic lupus erythematosus (SLE) was suggested to play a key role in the pathogenesis. To identify new methylation-sensitive genes, we integrated genome-wide DNA methylation and mRNA profiling data in CD4+ cells of MRL/lpr (MRL) and C57BL6/J (B6) mice. We identified Cathepsin E (Ctse), in which 13 methyl-CpGs within 583 bp region of intron 1 were hypomethylated, and Ctse mRNA upregulated in MRL compared with B6 mice. One of methyl-CpGs, mCGCG was 93.3 +/- 2.05% methylated in B6 mice, while 80.0 +/- 6.2% methylated and mutated to CGGG in MRL mice. Kaiso is known to bind to mCGCG and we hypothesized that it represses expression of Ctse in B6 mice. The binding of Kaiso to mCGCG site in B6 mice was reduced in MRL mice revealed by ChIP-PCR. EL4 cells treated with 5-azaC and/or Trichostatin A showed the suppression of binding of Kaiso to mCGCG motif by ChIP-PCR and the overexpression of Ctse was demonstrated by qPCR. Ctse gene silencing by siRNA in EL4 cells resulted in reduction of IL-10 secretion. The hypomethylation of mCGCG motif, reduced recruitment of Kaiso, and increased expression of Ctse and Il-10 in CD4+ cells may be involved in the pathogenesis of SLE.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2018Anti-High Mobility Group Box 1 Antibody Ameliorates Albuminuria in MRL/lpr Lupus-Prone MiceENHarukiWatanabeGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNo potential conflict of interest relevant to this article was reported.American Institute of PhysicsActa Medica Okayama0094-243X17072016Mathematical Formulation and Numerical Simulation of Bird Flu Infection Process within a Poultry Farm050013ENArrival RincePutriGraduate School Environmental and Life Science, Okayama UniversityTertia DeliaNovaAndalas UniversityMasajiWatanabeGraduate School Environmental and Life Science, Okayama University Bird flu infection processes within a poultry farm are formulated mathematically. A spatial effect is taken into account for the virus concentration with a diffusive term. An infection process is represented in terms of a traveling wave solutions. For a small removal rate, a singular perturbation analysis lead to existence of traveling wave solutions, that correspond to progressive infection in one direction.No potential conflict of interest relevant to this article was reported.American Institute of PhysicsActa Medica Okayama0094-243X17072016Numerical study on anaerobic digestion of fruit and vegetable waste: Biogas generation050017ENPuteri KusumaWardhaniGraduate School of Environmental and Life Science, Okayama UniversityMasajiWatanabeGraduate School of Environmental and Life Science, Okayama University The study provides experimental results and numerical results concerning anaerobic digestion of fruit and vegetable waste. Experiments were carried out by using batch floating drum type digester without mixing and temperature setting. The retention time was 30 days. Numerical results based on Monod type model with influence of temperature is introduced. Initial value problems were analyzed numerically, while kinetic parameters were analyzed by using trial error methods. The numerical results for the first five days seems appropriate in comparison with the experimental outcomes. However, numerical results shows that the model is inappropriate for 30 days of fermentation. This leads to the conclusion that Monod type model is not suitable for describe the mixture degradation of fruit and vegetable waste and horse dung.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812922017家族性大腸腺腫症術後20年後に小腸癌を発症した1例111114ENYuusakuSugiharaDepartment of Gastroenterology and Hepatology, Okayama University HospitalSeijiKawanoDepartment of Gastroenterology and Hepatology, Okayama University HospitalKeitaHaradaDepartment of Gastroenterological Surgery, Okayama University HospitalShihoTakashimaDepartment of Gastroenterology and Hepatology, Okayama University HospitalDaisukeTakeiDepartment of Gastroenterological Surgery, Okayama University HospitalToshihiroInokuchiDepartment of Gastroenterology and Hepatology, Okayama University HospitalMasahiroTakaharaDepartment of Gastroenterology and Hepatology, Okayama University HospitalSakikoHiraokaDepartment of Gastroenterology and Hepatology, Okayama University HospitalYoshikoMoriDivision of Endoscopy, Okayama University HospitalHiroyukiKishimotoDivision of Endoscopy, Okayama University HospitalTakeshiNagasakaDivision of Endoscopy, Okayama University HospitalHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University HospitalA 58-year-old Japanese man visited a local clinic for the evaluation of a stomachache. He was diagnosed with intestinal obstruction. His medical history included a proctocolectomy at the age of 38 years, due to familial adenomatous polyposis (FAP). He was referred to our institution, where he underwent a computed tomography examination and endoscopy of the small intestine. The pathological diagnosis was adenocarcinoma. No invasive or metastatic lesions were observed. Therefore, partial resection of the ileum with lymphadenectomy and reconstruction of the ileostomy were performed. Pathological examination revealed that the tumor was type 2, pT3 (SS) , pN1, pPM0, pDM0, pRM0, INFb, ly1, v1, pEX0, PN0. Twenty-nine days after the surgery, the patient was diagnosed with lung metastasis and he underwent lung radiofrequency ablation. We suggest that long-term follow-up is necessary for patients after surgery for FAP, because of the risk of malignant disease developing in other organs.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812912017アントラキノンの長期連用，及び摂取中止が大腸粘膜に与える影響2330ENEijiIwanoKamogata ClinicMasayaIwamuroDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Anthraquinone, an anthracene derivatives, is widely used as a purgative medicine. The long-term use of anthraquinone is known to cause melanosis coli and elevated lesions in the colon. However, the clinical course of patients who take anthraquinone over a long term and those who discontinue the drug has not been fully investigated. Here we investigated 22 patients who had colonic mucosal changes ( i.e., melanosis coli and elevated lesions) who had been taking anthraquinone for at least one year and discontinued it. We classified the elevated lesions into two subtypes:the small-lesion, which included multiple small nodules that were ＜ 2 mm in dia., and the large-lesion, which included a single or multiple nodules of ≥ 2-mm dia. We used colonoscopy to investigate the changes of colonic lesions between before and after the discontinuation of anthraquinone. The results indicated that the nodules of the small-lesion group were lymphoid follicle hyperplasia. In the large-lesion group, adenoma was most frequently observed ( n＝118) , followed by hyperplastic polyp ( n＝52) and inflammatory changes with edema ( n＝22) . Melanosis coli and elevated lesions were decreased or invisible after the discontinuation of anthraquinone. Our findings thus suggest that the long-term use of anthraquinone may cause some type of elevated lesions due to chronic inflammation. It is recommended that the use of anthraquinone be limited to a short term.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812812016回盲部潰瘍穿孔，食道潰瘍穿孔をきたした腸管Behçet 病の1 手術例2732ENYutaTsukumoKazuyukiKawamotoKoseiTakagiKaiChinYuriMatsubaYoshioNagahisaMichioOkabeYasuhiroShirakawaTadashiItohToshiyoshiFujiwara A 36-year-old Japanese man known to have incomplete Behçet’s disease (oral aphthous ulcers, genital ulcers, skin lesions, and esophageal and ileocecal ulcers) was admitted to our hospital in January 2011 for abdominal pain. We administered corticosteroids and immunosuppressants. Two months later, we performed an ileocecal resection to control gastrointestinal bleeding from the ileocecal ulcers. High fever persisted after this surgery, and upper gastrointestinal endoscopy demonstrated ulcer penetration between the lower and abdominal esophagus. Eighteen days after the initial ileocecal resection, we performed a lower esophagus resection, gastric tube reconstruction and enterostomy, during which we confirmed a 5-mm-dia. perforated site at the posterior wall of the abdominal esophagus. Postoperative anastomotic leakage and empyema occurred, but they were relieved by thoracic drainage and empyema dissection.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812812016原発性十二指腸粘液癌の一例― 本邦報告16例の検討―2125ENIkumiHamanoYusukeMatsumotoYoshikatsuEndoNaokiWatanabeKyouheiKaiShizouSatoYojiWani Primary mucinous adenocarcinoma of the duodenum is rare. Here we report a case we recently encountered, and we review 16 cases reported in Japan. An 82-year-old Japanese woman was admitted to our hospital complaining of abdominal pain and heartburn. An endoscopic examination revealed a Type 2 tumor in the descending limb of the duodenum, and endoscopically obtained specimens revealed a poorly differentiated adenocarcinoma. We performed a curative pancreatoduodenectomy with lymph node resection, and the surgical specimen revealed that the duodenum was the primary site of the mucinous adenocarcinoma. The patient is currently alive ＞ 1 year after the operation without any evidence of recurrence. Of the 16 patients reviewed, all patients had advanced tumors those depth were T3-T4. 9 patients had lymph node metastasis and 4 patients had peritoneal dissemination at the time of surgery. Since mucinous adenocarcinoma of the duodenum is often progressive cancer at a diagnosis, which is tend to have a worse prognosis than other histological types.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812732015長期のロスバスタチンカルシウム服用にて発症したと考えられる薬物性肝障害の一例219222ENAyanoOonishiKazuyaKariyamaAkikoWakutaMamoruNishimuraKazuhiroNousoA 67-year-old man was admitted to our hospital presenting with a liver injury. He had used several types of oral medication for the prior 2 years, including rosuvastatin calcium for hypertension, hyperlipidemia, and prostatic hypertrophy. His liver dysfunction was noted for the first time in February 2013, and at re-examination in March 2013 he showed exacerbation of the liver dysfunction, he was admitted to our hospital at that time. We stopped all of his oral medications, and his liver function improved steadily. We conducted a drug-induced lymphocyte transformation test (DLST), and the rosuvastatin calcium result was positive. He was diagnosed as having a drug-induced (by rosvastatin calcium) liver injury. He resumed oral medications other than rosuvastatin calcium from the time of discharge, with no exacerbation of liver dysfunction since then. Reports of drug-induced liver injury due to drugs with a long-term oral administration are extremely rare. We discuss the relevant literature herein.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812732015透析シャント心不全―非過大シャント心不全 “Non-High-Output Cardiac Failure”の病態―203207ENToyomuUgawaBackground: Hemodialysis-related heart failure has been considered to be associated with excessive blood flow through the arteriovenous (AV) shunt used for vascular access. However, some patients undergoing dialysis have heart failure in the absence of an increase in cardiac output (CO) related to shunt blood-flow loading because the loading cannot be compensated for by increasing CO. This condition may be challenging to manage ; thus, early diagnosis is important.
Methods and Results: Twelve patients (mean age, 71 years ; 9 men) with end-stage renal disease, dialysis-related heart failure, a high brain natriuretic peptide (BNP) level, and a mean New York Heart Association (NYHA) class of II underwent AV shunt closure. Their cardiac index (CI), pre- and post-dialysis BNP levels, and several cardiac variables were assessed pre- and postoperatively. All patients achieved relief of heart failure symptoms and a reduction in NYHA class after AV closure, but six patients had a postoperative increase in CI (the "non-high-output" cardiac failure group), whereas the other six had a decrease in CI (the "high-output" cardiac failure group). The high-output patients had greater improvements in BNP levels and most cardiac variables compared to the non-high-output group ;
therefore, the heart failure in the non-high-output patients was considered more serious than that in the high-output group.
Conclusions: The selection of effective strategies for treating dialysis-related heart failure may depend partly on identifying which patients have non-high-output failure. Such identification requires serial measurements of BNP levels and evaluations of cardiac variables other than the ejection fraction.No potential conflict of interest relevant to this article was reported.Taylor and FrancisActa Medica Okayama0169-186427152013Positioning device for outdoor mobile robots using optical sensors and lasers11471160ENIsakuNagaiGenkiYamauchiKeijiNagataniKeigoWatanabeKazuyaYoshidaWe propose a novel method for positioning a mobile robot in an outdoor environment using lasers and optical sensors. Position estimation via a noncontact optical method is useful because the information from the wheel odometer and the global positioning system in a mobile robot is unreliable in some situations. Contact optical sensors such as computer mouse are designed to be in contact with a surface and do not function well in strong ambient light conditions. To mitigate the challenges of an outdoor environment, we developed an optical device with a bandpass filter and a pipe to restrict solar light and to detect translation. The use of two devices enables sensing of the mobile robot’s position, including posture. Furthermore, employing a collimated laser beam allows measurements against a surface to be invariable with the distance to the surface. In this paper, we describe motion estimation, device configurations, and several tests for performance evaluation. We also present the experimental positioning results from a vehicle equipped with our optical device on an outdoor path. Finally, we discuss an improvement in postural accuracy by combining an optical device with precise gyroscopes.No potential conflict of interest relevant to this article was reported.IEEE Robotics & Automation SocietyActa Medica Okayama2015Path Tracking by a Mobile Robot Equipped with Only a Downward Facing Camera60536058ENIsakuNagaiKeigoWatanabeThis paper presents a practical path-tracking
method for a mobile robot with only a downward camera facing the passage plane. A unique algorithm for tracking and searching ground images with natural texture is used to localize the robot without a feature-point extraction scheme commonly used in other visual odometry methods. In our tracking algorithm, groups of reference pixels are used to detect the relative translation and rotation between frames. Furthermore, a reference pixel group of another shape is registered both to record a path and to correct errors accumulated during localization. All image processing and robot control operations are carried out with low memory consumption for image registration and fast calculation times for completing the searches on a laptop PC. We also describe experimental results in which a vehicle developed by the proposed method repeatedly performed precise path tracking under indoor and outdoor environments.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812722015超高齢者（95歳）の進行盲腸癌に対して腹腔鏡下回盲部切除を施行した1例117121ENAyakoWatanabeRyoInadaTakeshiNagasakaTomohikoYagiHijiriMatsumotoToshiakiToshimaSatoruKikuchiShinshiKurodaYoshitakaKondoYoshikoMoriHiroyukiKishimotoToshiyoshiFujiwaraWe report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials （RCTs） revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2015The Influence of Lifestyle on the Incidence of Dental Caries among 3-Year-Old Japanese ChildrenENMasakoWatanabeNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812712015岡山大学勤務医師による非常勤勤務を通した地域医療支援の現状調査1317ENSanaeTeshigawaraToshihideIwaseTatsuyaKanamoriTomokoKawabataMasaruSatoHitomiUsui Kataoka We investigated the situation of how physicians at Okayama University support local medical institutions by serving as a part-time worker, and analyzed the difference between the five medical districts of Okayama prefecture and other prefectures. Many physicians (actual number of physicians, full-time equivalent number of physicians) served in the southeastern region of the Okayama prefecture (339, 82.2). On the other hand, fewer physicians (42, 11.4) served in Takahashi・Niimi in the northwestern region of Okayama. Many physicians also served in Hiroshima prefecture (193, 48.8), Hyogo prefecture (109, 26.7), and the four prefectures of Shikoku Island (81, 23.6).
It has been clarified that many physicians at Okayama University are working on a part-time basis to support local and community medical institutions in the wide area of Okayama prefecture, Hiroshima prefecture, Hyogo prefecture and the four prefectures of Shikoku Island.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.岡山医学会Acta Medica Okayama0030-155812612014膵・胆管合流異常症―その概念と治療―1724ENTakuoNodaNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-31553199610の合成・分解の理解と習熟を図るための十面体のサイコロの効果的な使い方15ENNo potential conflict of interest relevant to this article was reported.岡山大学算数・数学教育学会Acta Medica Okayama1341-315572000高等学校学習指導要領の改訂について ―高等学校普通科の現場から―101103ENNo potential conflict of interest relevant to this article was reported.岡山大学農業生物研究所Acta Medica Okayama0029-08744331955拮抗微生物による作物病害防除研究 第10報 Trichoderma属菌利用による植物病害の防除 (その3) ポットおよび圃場試験134143ENY.NisikadoK.WatanabeNo potential conflict of interest relevant to this article was reported.岡山大学農業生物研究所Acta Medica Okayama0029-08744331955拮抗微生物による作物病害防除研究 第9報 Trichoderma属菌利用による植物病害の防除 (その2) 土壤中でのTrichoderma属菌の増殖,およびその大量培養と酸性物質との関係126133ENY.NisikadoK.WatanabeNo potential conflict of interest relevant to this article was reported.岡山大学大原農業生物研究所Acta Medica Okayama0029-08744021952蓮根の腐敗病に就いて 第一報115119ENY.NisikadoK.WatanabeNo 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 Okayama1883-24231532013合唱のウォームアップに関する考察(2)身体のリラックスの視点から5969ENMasakoMushiakiKaoriKuroi10.18926/bgeou/51107合唱のウォームアップについて，合唱指導者の取り組みや合唱団の事例を通して，身体の
リラックスの視点から考察した。野口体操や体ほぐしを取り入れた合唱指導者渡辺，岩崎，
橋本ら３者は，身体の柔軟性が良好な発声を導くという考えに基づいていることを示してお
り，また，岩崎，橋本は，心理的柔軟性もその条件に付加していることが明らかになった。
次に，合唱団の実践例から，全体的に，身体的な観点からは「呼吸」と「姿勢」を大切にし
た指導が行われ，上肢部分のストレッチに重点が置かれていることがわかった。他方，心理
的観点からは仲間との触れ合いを取り入れて心をほぐすなどの工夫が見られた。さらに，呼
吸と運動（動き）を同時に行う，合唱団員の年齢に応じた活動を取り入れるなどの工夫も見
られ，これらの活動が，息が自然に声につながるための手立てとなる示唆を得た。No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2013少量のミダゾラム投与による高血圧歯科患者の血圧安定化効果―二重盲検ランダム化比較試験―ENYoshihisaWatanabeNo potential conflict of interest relevant to this article was reported.岡山大学農業生物研究所Acta Medica Okayama0029-08744641959ヤマハンノキ芽枯病206217ENNo potential conflict of interest relevant to this article was reported.岡山大学農業生物研究所Acta Medica Okayama0029-08744421956蓮根腐敗病防除試験5664ENNo potential conflict of interest relevant to this article was reported.岡山大学農業生物研究所Acta Medica Okayama0029-08744321955拮抗微生物による作物病害防除硏究 第8報 Trichoderma属菌の利用による植物病害防除（その一） Trichoderma菌の各種菌核に対する抗菌作用103112ENNo potential conflict of interest relevant to this article was reported.岡山大学農業生物研究所Acta Medica Okayama0029-08744241955コムギ赤カビ病の第一次発生に関する硏究 第2報 子囊殻の形成について133141ENNo potential conflict of interest relevant to this article was reported.岡山大学農業生物研究所Acta Medica Okayama0029-08744231954蓮根の新病害炭疽病について8995ENNo potential conflict of interest relevant to this article was reported.岡山大学農業生物研究所Acta Medica Okayama0029-08744221954蓮根の腐敗病について 第2報 病原Fusarium菌の生態4956ENNo potential conflict of interest relevant to this article was reported.大原農業研究所Acta Medica Okayama0029-08744011951クリの葉枯病に就いて16ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812512013薬物相互作用(26―高尿酸血症治療薬の薬物相互作用）7375ENTakashiMakitaYoshihisaKitamuraToshiakiSendoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812432012術前化学療法により壁が菲薄化し組織学的寛解（pCR）となった巨大嚢胞内乳癌の１例243247ENTakakoImadaJunjiMatsuokaTakayukiMotokiTakayukiIwamotoMasakoOomoriSigemichiIhaToshieHongoNorikoHenmiMikioMakabeHiromiNogami A 31-year-old woman presented to our hospital because of a lump 5cm in diameter in her right breast. Ultrasonography revealed a multilocular cystic mass with partial thickening of the wall and the septum. Core needle biopsy (CNB) of the septum confirmed invasive ductal carcinoma. The patient was administered neoadjuvant chemotherapy consisting of 12 cycles of weekly paclitaxel followed by 4 cycles of FEC (5FU, Epilubicin and cyclophosphamide). While the thickness of the wall and septum became thinner, the tumor size did not change in diameter. She underwent right mastectomy and sentinel node biopsy. Post-surgical histopathological findings showed a pathological complete response (pCR).<br>
We report a rare case of invasive ductal carcinoma presenting a multilobular phenotype which showed pCR by neoadjuvant chemotherapy despite no size reduction of the tumor.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812322011上腕骨外側上顆炎の診療ガイドライン141144ENYasunoriShimamuraMadokaInoueMasatuguOzawaTomokoKanazawaTaiichiSaitouRyuichiNakaharaTomoyukiNodaKeiichiroNishidaToshifumiOzakiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812322011テロメラーゼ依存的腫瘍融解アデノウイルス製剤による 放射線感受性増強作用103109ENShinjiKurodaToshiyaFujiwaraYasuhiroShirakawaYasumotoYamasakiSyuyaYanoFutoshiUnoHiroshiTazawaYuuriHashimotoYuichiWatanabeKazuhiroNomaYasuoUrataShunsukeKagawaToshiyoshiFujiwaraDNA修復機能阻害は放射線感受性を増強させるため，DNA修復に関与する因子の阻害剤は放射線増感剤となり得る．我々の開発したテロメラーゼ依存的腫瘍融解アデノウイルス製剤OBP-301（テロメライシン）は，アデノウイルスE1B55kDaタンパクを介して細胞のDNA修復に重要な役割を果たすMRN複合体（Mre11，Rad50，NBS1）を分解する機能を有する．このMRN複合体の分解によりATM（ataxia-telangiectasia mutated）の活性化が抑制され結果的にDNA修復機構が阻害される．我々はOBP-301と放射線との併用が強力な相乗効果を生み出すことをマウスの皮下腫瘍モデルおよび食道癌同所性モデルにおいて証明した．これらの結果はOBP-301が将来有望な放射線増感剤となり得ることだけでなく，E1B55kDaタンパクを産生する腫瘍融解アデノウイルス製剤と放射線との併用が悪性腫瘍に対する有力な治療戦略となり得ることを示す．No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812312011成人先天性胆道拡張症の6例3943ENHirotoshiTakashimaAkiraSasakiKaoruSasakiWe report six patients with adult congenital biliary dilatation treated by surgery. Of the six cases, five were female and the patients' age at diagnosis ranged from 19 to 51 years old. By Todani's classification for bile duct dilatation, three were categorized as Ta, one as Tb, and two as Wa. All six cases had anomalous arrangement of the pancreatobiliary duct. Resection of the cystic portion and hepaticojejunostomy (Roux-Y) were performed in all. After surgery, one patient classified as Ta and one as Wa had complications of cholangitis and intrahepatic stones. We removed the stones by the percutaneous transhepatic route with dilatation of the stenotic anastomosis, but cholangitis recurred in the Wa patient. Although surgical resection of the cystic portion and reconstruction of biliary tract is considered to be a standard treatment for adult congenital biliary dilatation, this Wa case had complications after surgical treatment. Thus short-term follow-up is necessary to prevent or diagnose stenotic anastomosis following the operation.No 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 Okayama0030-15586421952外科領域に於ける血液プロトロンビンに関する臨牀的研究 第4篇 ビタミンK投与の血液プロトロンビン指数に及ぼす影響193200ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586421952外科領域に於ける血液プロトロンビンに関する臨牀的研究 第二篇 2〜3外科的疾患に於ける血液プロトロンビン指数に就て172184ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586421952外科領域に於ける血液プロトロンビンに関する臨牀的研究 第1篇 血液プロトロンビン測定に関する基礎的研究165171ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15586931957悪性絨毛上皮腫の統計的観察737743ENIchiroWatanabeStatistical studies were carried out on seventy eight in-patients with chorioepithelioma at the Gynecological Dept. of Okayama University Medical School during the period from 1945 to 1955. The following results were obtained. The frequency of chorioepithelioma cases was 0.5 per cent, of gynecological in-patients during the said period, and average ages of these in-patients were thirty five years. Cases caused by hydatidiform moles were 57, 69 per cent and by artificial abortions, which have been remarkably prevailing after the end of the last World War, formed 10.25 per cent, of these in-patients. As for the latency period, it was less than six months on 90.75 per cent of these in-patients. Further, the followings were observed that most of these in-patients presented the symptoms of anemia, and 92.75 per cent of them had abnormally big uterus and on 42.62 per cent of these in-patients, cystic swells in the ovaries were seen. Besides, 44.87 per cent of them were subjected to metastasis, particularly on their vaginas and lungs, and on the external genitals, cerebrum, abdomen and bladder in frequent order. Methods of treatment, applied on these in-patients, were as follows. Operation (total hysterectomy has been adopted in principle at this Dept): 39.74 per cent Combined method of operation and radiotherapy: 46.15 per cent Radiotherapy method: 11.53 per cent Chemotheraphy method: 2.56 per cent The prognosis of these in-patients, after the foresaid treatment, were as follows. Primary death during treatment: 15.28 per cent In-patients, concluded to be incurable at the time of leaving of this Dept: 7.67 per cent In-patients, favourably recovered: 26.92 per cent In-patients, recovered temporarily: 50.00 per centNo potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30691011978「現代複合経営」の成立条件とその意義について126ENM.Watanabe10.18926/OER/42276No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30691531983岡山県南工業地帯における労働市場の展開と中山間部農業の変貌〔II〕―農業のシステム化と農法問題―87121ENMotoiWatanabe10.18926/OER/42130No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30691521983岡山県南工業地帯における労働市場の展開と中山間部農業の変貌〔I〕―農業のシステム化と農法問題―145ENMotoiWatanabe10.18926/OER/42123No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30691631984下野克己著『戦後日本石炭化学工業史』への若干の問題提起179187ENTokujiWatanabeNo potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30691611984国民食糧の生産と農協加工事業，その地位と役割126ENMotoiWatanabe10.18926/OER/42082No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30691921987農協経済連事業の動向―鹿児島・山口を対比して―3175ENMotoiWatanabe10.18926/OER/41979No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama0386-30693041999原価計算システムの目的適合性，写像性，およびコンテクスト―原価計算システム変化論の視座―267302ENTakeoWatanabe10.18926/OER/41573We have argued that cost accounting system should be modified in accordance with the purpose for using them and the context. Because no cost accounting system that is relevant in every business or environment exists. Relevant cost accounting system is determined in a particular
environment and context. This mode of thought relates directly to proposition which develops to explain the theory of 'cost accounting change'. This paper examines the relationships among the purpose, reflexibility and contexts of cost accounting system. The analysis based on reflexibility theory and some previous studies for activity-based costing and contingency theory indicated that: 1) Actual reflexibility about existing cost accounting was associated with two contextual variables: product diversity and process complexity. 2) A reflexibility required
mainly through the purpose for using cost accounting was associated with two contextual variables: competitive strategy and perceived environment uncertainty. Finally, we concluded that the relevance of cost accounting was lost and 'cost accounting change' became necessary when
the level of actual reflexibility didn't fit that of required reflexibility.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587110-21959Urobilin体の定量に関する研究 第2篇 加熱時のAldehyde反応69676975ENHaruoWatanabe1. The comparative studies were photometrically observed on the reacting solution after the aldehyde reaction of each proportion separated from urine by the Weiss's method at the room temperature or in heating and it was clarified, that the pigment occupied the important region of increasing the red tone was the II proportion of histidin and the origin of it's pigment was indican, by the paperchromatography. The substance of indole system was contained in the urochrom proportion and histidinel L proportion and it increased the red tone in heating, but the rate of increasing the color was low as compared with indican. 2. The combined substance of indoxyl-aldehyde i. e. Goessner's pigment became red in the polar solvent and yellowish brown in the unpolar solvent, and it changed to red over the pH 4 and yellowish brown below the pH 4. Therefore, it was yellowish brown with the absorption maximum at 474 mμ under the condition in the aldehyde reaction of urine, but it became having a red tone on the density of indican over 3mg dl. 3. The relation of urobilinogen was often observed on the red tone appeared at the first period, in heating after the addition of aldehyde reagent into urine.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587110-21959Urobilin体の定量に関する研究 第1篇 Urobilin体定量法の検討69536965ENHaruoWatanabeThe Terwen's reduction method and the methods reported by Heilmeyer, Krebs and Watson were fully observed. And the results were as follows. 1. Urobilin was completely reduced to urobilinogen within 2 hours by the Terwen's method, and the highest uroblinogen value was observed on the mixed rate of the materials and the reducing agents in 40:5:5. The materials should be stored, under the isolation of air and light, at the low temperature as possible and there was a limitation for the preserved time. 2. The optimal range of pH for the extraction of urobilinogen into the solvont. 3. It was demonstrated that petroleum ether was the best solvent for the extraction of urobilinogen since the comparative studies on the various solvent, especially between ether and petroleum ether. 4. The composition of regent needed the concentration of 0.3% P-dimethylaminobenzaldehyde on the use of 60% hydrochloric acid and of 1% P-dimethylaminobenzaldehyde on the use of 50% hydrochloric acid. 5. The shaking process for one minute was needed till the addition of sodium acetate after the addition of regents, urobilinogen in the solvent was extracted into hydrochloric acid in the regent and the reaction was performed in the water layer by the above treatment. The progress of aldehyde reaction on this occasion was considerably quantitative. 6. The significance of adding sodium acetate was to shift to nearly the pH 4 after the terminal reaction and was to remove the coloration by indole body, with bringing the coloration of urobilinogen up to the highest and keeping the stability of it. 7. The influence of indole, indican, P.A.S. and sulfonamid derivatives shown the similar reaction in the qualitative test could be eliminated on the quantitive method.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558719-21959無カタラーゼ血液症における歯科学的研究 I. 剥離細胞学的検索59115920ENYoshioWatanabeToshiyukiMatsuiYoshioShiraishiExfoliative cytologic findings of the oral mucosa in three cases of Acatalasemia (Takahara's disease) were investigated by means of Papanicolaou's method. Three cases were sisters of the same family, 19, 22, and 15 years of age. Oroantral fistula was noticed in the left molar area in Case 2 and Case 3 complained of loosening of anterior lower teeth with marginal gingivitis in the left lower molar ares. Smears were prepared by the following technics: 1) Scraping four different areas of the oral mucosa---hard palate, gingiva, radix linguae and buccal mucosa without causing bleeding. 2) Sediment taken from centrifuged mouth washings by physiologic saline solution. 3) Cells caught by membrane filter or both of them. All the smears were stained by Papanicolaou's technic and histologic examination of the gingiva was made in comparison with cytologic smears in Case 3. Thus keratinization of the epithelial cells were studied. 1) Keratinizing tendency was the same as those of normal mucosa in Cases 1 and 3. In the ulcerating area of Case 3 keratinized cells showed an increase as healing was going on, while they showed a marked decrease in Case 2, which might be due to the decrease of local resitance associated with ulcerative changes and the influence of partial denture. 2) Exfoliated cells of the whole oral mucosa in case of mouth washings Cases 1 and 3 showed the same findings as normal cases and Case 2 showed a marked decrease of keratinized cells. These findings were same as those of four different areas of the oral mucosa. 3) Gingiva of Case 3 showed little difference from normal mucosa in histopathologic findings.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558717-21959凍結乾燥菌の酵素的性状について 第2編 Staphy. aureus, albus44794485ENSyunsukeWatanabeUsing the standard strains of Staphy. aureus and albus stocked in author's department, the author carried out the investigations just in same way as preceeding paper (Part I). The results obtained are following. 1) The freezing-dried cells of both strains showed increased permeability to inhibitors, namely, KCN, NaN(3), NaF, and HXA, compared with the fresh cells of these bacteria. 2) The oxydation of succinate by the freezing-dried cells of both strains were not inhibited in the presence of malonate, while that oxydation by Sal. typhi was inhibited. 3) The oxydation capacity for pyruvate were markedly decreased on the freezing-dried cells of both strains. 4) In the sight of stoichiometrical studies, it could be postulated that the oxydative degradation of glucose by freezing-dried cells of Staphy. aureus might be carried out mainly through the Embden-Myerhof's pathway; and the Warburg-Dickens' shunt was also supposed to be present in the fresh cells of that bacteria. The other pathway for the degradation was thought to be exist in Staphy. albus in either case, fresh or freezing-dried.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558717-21959凍結乾燥菌の酵素的性状について 第1編 Sal. typhi 57S, R44714478ENSyunsukeWatanabeUsing the standard strains of Sal. typhi 57 S and R taken from the departmental stock, the author investigated the effects of freezing-drying treatment of bacteria on the specificity of their substrates, the permeability of inhibitors, and the properties of enzyme system, and also observed the differences in enzymatic properties of two strains. The following results were obtained. 1) It was observed the increased permeability of the surface of cells treated by freezing-drying method to inhibitors; NaN3, NaF and HXA. 2) Both strains of bacteria tested could not oxydize gluconate and citrate in fresh state, whil the freezing-dried cells of Sal. typhi 57 R could that in some extent. 3) There was marked decrease of the oxydation capacity for pyruvate by the freezing-dried cells of both strains. 4) From the viewpoint of stoichiometrical studies, it could posturate the presence of different pathway for the degradation of glucose besides Embden-Myerhof's pathway, presumably Warburg-Dicken's shunt, in the fresh cells of Sal. typhi 57 R. But in the freezing-dried cells of both strains the degradation might be carried out through Embden-Myerhof's pathway.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810111-121989Guanidinoethanesulfonic acid誘発痙攣に関する研究―特に脳内モノアミンにおよぼす影響―977989ENShunjiWatanabeGuanidinoethanesulfonic acid (GES) is known to induce convulsive seizures when administered intracisternally into rabbits and cats. I examined the effects of GES on behavior, electroencephalogram and brain monoamine levels after intraventricular injection into mice. When GES was intraventricularly injected into mice, focal clonic movements of the face, vibrissae and ears, as well as twitchings of limbs were observed 0.5-1 min after injection. Hypersensitivity was observed until 7 min after the injection, after which the mice behaved in a normal way. It is also observed that GES induced sporadic spike discharges in the electroencephalogram. The latency and duration of the appearence of spike discharges showed considerable individual variation. The latency was from 0 to 5 min, and the duration was from 5 to 90 min. No spike discharge was observed in the saline injected animals. The 5-hydroxytryptamine (5-HT) level decreased in the hippocampus, diencephalon, pons-medulla oblongata and cerebellum 5 min after injection, and recovered to the control level 10 min after the injection. No change in the norepinephrine (NE) and dopamine (DA) levels was found after GES injection. 5-hydroxyindoleacetic acid increased in the striatum and cerebellum 5 min after injection. It is thought that the GES injection enhances the release of 5-HT in the striatum and cerebellum, although the mechanism of the decrease of 5-HT in the hippocampus, diencephalon and pons-medulla oblongata is unclear. These results indicate that the GES induced convulsive seizure is related to 5-HT neurons, not NE or DA neurons.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581015-61989先天性心膜欠損症における心臓超音波所見（体位変換による所見の変化）487494ENKazuyoshiHinaMasayukiUeedaShinjiUchidaMasahiroHasuiTsutomuMimaHirofumiWatanabeDaijiSaitoTakaoTsujiKatashiMatubaraHidenoriYoshidaShoichiHaraokaKohichiroIwasakiShozoKusachiToshimasaKitaThe true incidence of congenital pericardial defects is unknown, but it is more common than generally supposed. Because of the variance of chest X-rays, ECG and symptoms according to the degree of the defect, it is still not easy to diagnose a pericardial defect. Recently, we experienced four patients with congenital pericardial defects. Three cases were absence of the left pericardium and one was an absence of the right. In these patients, the view with echocardiography was characteristically altered by posture changes. All three patients with left-sided defect showed an enlarged right ventricular cavity, paradoxycal motion of the interventricular septum and hyperkinetic motion of the posterior wall in the left lateral decubitus position. These findings were not present in the right decubitus position. On the other hand, in a case with a right-sided defect, the view was almost normal in the left decubitus position. In the right decubitus position, the right ventricular cavity enlarged and the interventricular septum moved hyperkineticaly. These alterations of echocardiographic findings by posture changes were specific to the side of the pericardial defect, and were caused by a change in cardiac restraint. Therefore, an echocardiogram recorded with posture changes is useful in the diagnosis of congenital pericardial defects.No potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142191957花崗岩に関する諸問題 （9） 日本の花崗岩と鉱床との関係5256ENNo potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142291961陰イオン交換樹脂によるウランの分離に関する研究719ENShunjiUmemotoMasanobuSakanoue10.18926/40220No potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142361966人形峠ウラン鉱山，中津河鉱床南部鉱体の微量元素について2330ENKojiWatanabe10.18926/40197The Nakatsugo Deposits are the main deposits of the Ningyo Toge Mine which is located in the northern part of Okayama Prefecture. Nakatsugo Deposits consists of the two main ore body, namely, Nanbu Kotai (southern ore body) and Hon Kotai (main ore body). Nanbu Kotai is occupied mostly by the unoxidized zone and high grade ores containing ningyoite (n% U) are widely found in the basal conglomerates. Minor elements in the common rocks such as basal granites, conglomerates, sandstones, dikes, and shales as well as the uraniferous ores were determined quantatively by fluorescent X-ray spectrometric analysis (for U, Zr, Y, Sr, As, and Fe) and spectrophotometric analysis (for Ni and Co). As the results of this study, it is found that the uraniferous ores are characterised by extremely high contents of Zr, Y, Sr, and As, which show positive and linear correlation with the U contents. It is confirmed that As is concentrated in pyrite which is usually associated with the uraniferous ores. Elements such as Ni and Co are slightly concentrated both in the uraniferous ores and andesite dikes. This fact may suggest some genetic relationship among them. However, it does not seem to be plausible to draw any definite conclusion on the origin of the uranium deposits from these relationships. As to the minor element distribution in common rocks, no systematic variation was found except for the rock samples closely associated with the ore deposits.No potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142411972炭酸塩の酸素および炭素同位体比の測定について912ENMakotoWatanabeOsamuMatsubaya10.18926/40150Oxygen and carbon isotopic ratios of two working standards of our laboratory and three other standards were measured by McCrea's technique
and the new McKINNEY type mass spectrometer in
this Institute. The reproducibility of δ(13)C measurement is about ±0.2‰. Some systematic differences in δ(18)O values were observed among the three measurements in Apr.-May, July, and Aug., 1971. Because these systematic differences are supposed to be caused by the imperfection
in the processes of decomposition of carbonates
by phosphoric acid, the reproducibility of δ(18)O
measurement may be ±O.2‰ in most cases. The calibrations of our working standard, CK-13, against the PDB standard were carried out on the assumption that δ(18)O and δ(13)C of CK-13 are -1.75‰ and +O.54‰ relative to PDB, respectively. The accuracy of these calibrations is about ±O.2‰ as shown by the interlaboratory comparison of some standards (Table 3). The δ(18)O values of the two working standards relative to PDB are independently recalculated relative to SMOW based on the two assumptions (Table 4). One of which is that a standard water MSA-2 is -8.20‰ relative to SMOW, and the other is that the δ(18)O of CK-13 is -1.75‰ relative to PDB. The results of both calculations agree within 0.4‰.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010西宮渡辺病院175176ENNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama2010歯科臨床における感染予防対策意識と行動についての現状と課題 −某県歯科衛生士会会員に対する意識調査から−ENAkariWatanabeNo potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142341964大山の地下水の溶存ガスの定量5362ENKojiWatanabeTakaharuOkuno10.18926/21324鳥取県大山火山の西北麓の地下水中に潜存するガス成分比は Ar : 0.34〜0.40 (cc/l) 1.48〜1.64 (%) O(2) : 6.69〜9.08 (cc/l) 27.92〜35.30 (%) N(2) : 15.16〜17.23 (cc/l) 63.22〜67.92 (%) の範囲内で定量できる.また,飽和度は次の如くである. O(2) : 87.8〜113.9 (%) N(2) : 110.5〜123.2 (%) この結果を地表水と比較して,O(2)の飽和度は小さいが,量的な差異はあまりみられず,地表水と地下水の中間的な性質を示している.地質構造,地形が溶存ガス成分比に及ぼす影響は,地下水の流通経路が長距離とみなされる場合に若干のO(2)の消費が認められ,短距離で湧出したと思われるものにはO(2)の飽和度が大きい傾向がある.また,水理地質的にみて,地質と湧出量には密接な関連を見出せるが,ガス成分には影響を与へてはいない.No potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142341964鳥取温泉におけるボーリング･コアの組成鉱物について4152ENKojiWatanabe10.18926/21323鳥取温泉の深度300mに及ぶ試錐のボーリング･コアを検討した結果,主成分鉱物として,石英,長石類(斜長石,加里長石,)と二次的生成鉱物としてモンモリロナイト,カオリナイト,イライト,緑泥石,黄鉄鉱などを認めた.このうち,イライトは堆積岩中に普遍的に存在し,更に緑泥石も全般的にしかも第三紀層で多量に認められている.モンモリロナイトは方解石と共に温泉による生成が考へられ,また,カオリナイトは表土層にのみ認める事ができる.一方,加里長石,黄鉄鉱,緑泥石の産出状態,及びコアが示す粒度,酸化状態からして第四紀層の堆積環境が推定され,25mを境として下部は数回の陸化を含む浅い堆積層であるのに対し,上部は比較的深い.背後供給地から離れた海成層を示唆する.No potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142341964鳥取県東郷鉱山ウラン鉱床の基盤岩ならびに母岩の変質 (1)方面･麻畑鉱床2140ENKojiWatanabe10.18926/21322東郷鉱山,方面･麻畑ウラン鉱床の基盤岩および母岩は粘土化が著しく,その特徴として次のことが挙げられる. (a)粘土鉱物の種類,存在量は,鉱床の酸化帯･非酸化帯にはゞ規制されている.(b)粘土化の程度は原岩の種類により異なり,同一種数の岩石では酸化帯における変質が特に顕著である.(c)粘土量とウラン含有量との間には明確な相関は見出せないが,モンモリロナイトの量についてのみ観察すると,おおよそ負の相関がみられる.また,粘土化の主体をなすモンモリロナイトは,結晶度が良好で熱水変質が示唆きれる.化学分析の結果,SiO(2)の量が少ないので珪ばん比が異常に小さいが,ウラン鉱床近辺においてモンモリロナイト化に伴なう珪化帯が認められず,珪酸の逸脱が考えられる.鉱量的にみて,両鉱床の主体をなすウラン鉱物が燐顧塩鉱物であり,珪酸塩鉱物が少ないことなどから,モンモリロナイト化作用と鉱化作用との間には,直接関連がないものと考察される.No potential conflict of interest relevant to this article was reported.岡山大学温泉研究所Acta Medica Okayama0369-7142341964岡山県奥津カオリン鉱床の放射能異常110ENTakaharaOkunoKojiWatanabe10.18926/21320奥津カオリン鉱床は花崗緑岩中の熱水交代性の塊状粘土鉱床であって, 中心部に白色粘土鉱体, それをとりまいて石英沸石帯,更にその外側に緑簾石帯からなる変質の帯状分布が存在する. 放射能異常は外側変質帯の緑簾石帯に集中しており, そこにトリウムの濃集が認められる. 本鉱床の放射性元素の濃集は変質帯形成の機構と密接に関連するものとみられる.No potential conflict of interest relevant to this article was reported.岡山実験動物研究会Acta Medica Okayama51987グッピー集団の一過性過剰移動1013ENMunetakaWatanabeNo potential conflict of interest relevant to this article was reported.岡山大学環境管理センターActa Medica Okayama0917-1533252003実験結果と数値シミュレーションによるポリマー生分解性解析2532ENMasajiWatanabeFusakoKawaiWe describe techniques that we developed previously in studies of biodegradation of polymeric compounds. We present some experimental results concerning biodegradation of polyethylene. We introduce a mathematical model that govern the evolution of the weight distribution, and show how its inverse problem can be analyzed. We also introduce a mathematical model that governs the evolution of the weight distribution of polymeric compound subjected to enzymatic degradation, and present some numerical results concerning enzymatic degradation of polyvinyl alcohol.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 Okayama0917-1533262004数値シミュレーションによるポリエチレングリコール生分解性解析1722ENMasajiWatanabeFusakoKawaiWe examined the biodegradability of polyethylene glycol by analyzing gel permeation chromatography patterns, which were obtained before and after cultivation of a microbial consortium E-1 in culture media containing polyethylene glycol as its sole carbon source. We solved an inverse problem of the initial value problem, which consists of an exogenous depolymerization model and the initial weight distribution, in order to determine an oxidation rate, for which the solution of the initial value problem also satisfies the final condition. Given the oxidation rate, we simulated the transition of the weight distribution solving the initial value problem. We interpret the result that reflects a physical significance of the molecular weight on the oxidation rate, and reach a conclusion concerning the role of the membrane transport in
exogenous depolymerization processes.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812212010Focal adhesion kinase (FAK) と Insulin-like growth factor-I receptor (IGF-IR) に対するデュアルチロシンキナーゼ阻害剤の食道腺癌における抗腫瘍効果1725ENNobuyukiWatanabeMunenoriTakaokaKazufumiSakuramaYasukoTomonoShinjiHatakeyamaOsamuOhmoriTakayukiMotokiYasuhiroShirakawaTomokiYamatsujiMinoruHaisaJunjiMatsuokaDavid G.BeerHitoshiNagatsukaNoriakiTanakaYoshioNaomotoNo potential conflict of interest relevant to this article was reported.岡山大学環境理工学部Acta Medica Okayama1341-9099411999Photoconductive and Photovoltaic Properties in Cadmium Bismuth Aluminate Glasses147158ENDanpingChenTomohiroWatanabeYoshinariMiuraTokuroNanba10.18926/fest/19742Photo-induced phenomena such as photoconductive and photovoltaic effects were investigated for the glasses in CdO-Bi(2)O(3)-Al(2)O(3) system. Photoconductive effect was characterized by a slow decay of photocurrent (persitent photoconductivity). The decay rate decreased with increasing CdO content and decreasing Bi(2)O(3) content. Photovoltage was very small at room temperature but increased to an obvious value on heating. The photoconductivity and photovoltage were increased with CdO content and enhanced by heat treatment in air. The valence band spectra of X-ray photoelectron spectroscopy showed that the hybridization of Cd 4d and O 2p orbitals increases with decreasing Bi(2)O(3) content and increasing CdO content in the glasses. As the results maximum tends to flat. This type of band structure inhibits the rapid recombination of electrons and holes. The persistent photoconductivity of the glasses may be attributed to deep energy level of DX centers. Deep energy levels of the glasses are able to prevent the recombination because they have a repulsive barrier for both electron emission and capture.No potential conflict of interest relevant to this article was reported.岡山大学環境理工学部Acta Medica Okayama1341-9099411999Circadian Oscillations in Systems of Biochemical Oscillators Coupled to Stationary Systems16ENMasajiWatanabe10.18926/fest/19695According ot previous studies, we may expect that slow oscillations can occur in dynamics of a parameterized family of systems in which a biochemical oscillator is coupled to a stationary systems. We introduce some numerical results that confirm our expectation. The results suggest that it is possible for slow oscillations to occur in dynamics of a system in which an active oscillatory unit is coupled to a passive medium, and that it is possible for circadian oscillations to arise from fast glycolytic oscillations in such a coupled system.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587071958Phenolkampfer関節内注入の実験的並びに臨床的研究 第3編 Phenolkampfer関節内注入の臨床的経験24972504ENTakashiWatanabe1) Satisfactory results were obtained in the treatment of 22 patients of rheumatoid arthritis with intractable pain, who were not benefitted by general and local application of steroid hormone or who were not suitable for hormone therapy for side effects or associated diseases. 2) Pain on intraarticular injection of Phenolcamphor is alleviated by gradual increasing of dosage, because of its toleration. 3) Other drugs should not be injected even in which pain increases following injection of Phenolcamphor and Phenolcamphor should be injected repeatedly after evacuation of intraarticular fluid until the pain subsides. 4) Decrease of pain was marked and swelling of joint completely subsided in a chronic case with fluid accumulation in joints. There was found no relationship between severity of symptoms and of functional disturbance and effects of Phenolcamphor. 5) Effects of Phenolcamphor were persistent and neither pain, swelling and accumulation of fluid in joint recurred nor functional disturbance and adhesion developed in the case in which effects of Phenolcamphor were noted. 6) Intraarticular injection of Phenolcamphor should be attempted as a kind of local stimulant therapy in cases which hormone therapy was not effective or contraindicated and no choice of treatment was left except orthopedic method.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587071958Phenolkampfer関節内注入の実験的並びに臨床的研究 第2編 Phenolkampfer関節内注入時皮膚及び関節内温度についての実験的研究24872495ENTakashiWatanabeCorrelations between intraarticular changes and local findings and skin surface and intraarticular temperature following Phenolcamphor injection were studied to assure the possibilities of anticipating its effects and courses following Phenolcamphor injection by measurement of temperature. Phenolcamphor were injected into knee joints of three groups of normal rabbits in which 0.25 cc and 0.5 cc of Phenolcamphor, and mixed solution of 0.25 cc of Phenolcamphor and 0.25 cc of water as control were given. Temperature was measured with electric thermometer. 1) Close relationship were found between intraarticular changes and local findings, and skin surface and intraarticular temperature following intraarticular injection of Phenolcamphor. Temperature rose with increase of local inflammatory signs and falls with its regression and stabilized after two or three weeks. 2) Parallel correlation was found between skin surface and intraarticular temperature with a little high level in the latter. 3) No difference in changes of temperature was found in different amount of injected Phenolcamphor, though the Peak of temperature rise was noted slightly later in the case of a small amount of injected material than in the large amount. 4) It is of significance for observation of effects and course of Phenolcamphor injection to measure skin surface and intraarticular temperature. However, it is not feasible to measure frequently intraarticular temperature and also it is hardly acceptable to inject procaine into joint for the relief of pain in measurement of intraarticular temperature. It is not applicable to clinical use, hence measurement of skin temperature should be used as substitute for it.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587071958Phenolkampfer関節内注入の実験的並びに臨床的研究 第1編 正常家兎膝関節内Phenolkampfer注入実験24732486ENTakashiWatanabePhenolcamphor has been used for prevention of infection and for treatment of injury and suppurative inflammation of knee joint since the World War T. Effects of Phenolcamphor in joint, especially regarding its corrosive action, were studied. Anatomical changes developing in joint were studied macroscopically and histologically by means of Hematoxylin-Eosin and PAS stain in two groups of rabbits in which 0.25 cc and 0.5 cc of Phenolcamphor were injected into knee joint, respectively. 1) Phenolcamphor properly prepared after original method neither produces necrosis of synovial membrane and articular cartilage nor has corrosive action. 2) Phenolcamphor must be carefully injected, for arthritis deformans would be caused by technical error, and its possibility is enhanced by presence of injury of articular cartilage. 3) Effects of Phenolcamphor continues so that persistent congestion is present in synovial membrane, and dilatation of small vessels, round cell infiltration and hyperplasia of connective tissue are histologically barely noticeable. A small amonnt of serous exudate accumulates, however, neither adhesion nor functional disturbances are produced.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587041958乳歯斑状歯の研究11911215ENShimpeiWatanabeAttention has been paid to the mottled tooth since the report of Black and McKay in 1916. Thereafter the developing mechanism of mottled teeth has been made clear to some extent by many examinations and studies, but the majority of them is that of the permanent tooth and very few works have been made on the deciduous tooth. What these few works agree in their opinions with each other is that incidence of mottled deciduous teeth is lower than that of permanent ones, but the reason for this difference is still in the stage of speculation. The results of clinical and experimental studies on the mechanism of development of mottled deciduous teeth are described in this paper. Material and Methods: The Th-Neo-Thorin Method was used for determination of fluorine. All the materials used were distilled and only the fluorine ion was isolated. 1) Numerous cases of mottled deciduous teeth were discovered when investigation of mottled teeth had been carried out in Tomita District, Tamashima City and Konko Town in Okayama Pref. in 1953. The results obtained from the studies on the relationship between their incidence and caries of deciduous teeth and on determination of the fluorine content in drinking water are as follows: a) Average number of the persons with mottled teeth was 47.84 per cent in the permanent teeth and 15.23 per cent in the deciduous teeth, in the ratio 3 to 1. And the degree of mottled teeth was M(1) in most cases and M(2) in few cases and no M(3) could be found. b) Minimal threshold of fluorine in the incidence of mottled teeth was approxiamtely 1.0 ppm. in the deciduous teeth, while 0.5 ppm. of fluorine caused mottled teeth of degree of M(1). c) Caries incidence of the deciduous teeth was as low as that of the permanent teeth; and caries incidence in case of mottled deciduous teeth was lower than that in case of permanent ones. 2) The following experiments were performed for the purpose of investigating the role the placenta played in the fluorine metabolism during pregnancy: First, the fluorine content in the placenta of pregnant women and in the drinking water taken by them selves during the pregnancy were determined both in fluorine and non-fluorine districts. Then oral examinations of the children of the mothers in the fluorine district were conducted. And the rationship of incidence of the mottled deciduous teeth to the content of fluorine in the placenta and in the drinking water was investigated and the fluorine content of the deciduous teeth was determined at the same time. The results obteined were as follows: a) When the mother took a large amount of fluoride, some of fluorine was retained in her placenta, while the rest pessed through the placenta and had an effect on the embryo. b) The higher was the content of fluorine in drinking water, the larger was the amount of fluorine retained in the placenta. c) A small amount of fluorine could be recognized in the control placenta taken from the non-fluorine district. d) Incidence of mottled deciduous teeth was dependent upon the fluorine content of drinking water. e) The larger the content of fluorine in drinking water, the more frequently seen the incidence of mottled deciduous teeth with its minimal threshold of 1.0 ppm. f) Fluorine of 334.4 ppm. on average was contained in the mottled deciduous teeth, i.e. about one third of fluorine in the mottled deciduous teeth. 3) The following animal experiments were performed in order to confirm those results mentioned above in human: Rabbits were used as experimental animals to investigate what amount of fluorine was retained in the placenta and to what extent it was transmitted to her embryo and, moreover, to determine whether there was any limit in the retention of fluorine within the placenta. a) When 0.5 mg./kg. or 1.0 mg/kg. of NaF was administered, no significant change was noticed in the fluorine content of the placenta as compared with that of the control, but maked retention of fluorine was seen, when 5.0 mg./kg. or more of NaF was given. b) When a large amount of NaF, ranging 10.0 mg./kg. to 20.0 mg./kg. was administered, fluorine passed through the placenta and was transmitted to the embryo. From the results obtained by these experiments it could be concluded that the placenta plays a definite role in fluorine metabolism during the pregnancy and its retention has an influence on the incidence of mottled deciduous teeth.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587211-121960Cushing氏症候群の一例21372144ENHaruoWatanabeTaiseiMonobeShosoNakagawaMinoruShindoThe authors report a case of Cushing's syndrom with typical clinical pictures, that is, generalized adipositas, full moon face, cutaneous striae, hypertension, osteoporosis, hyperglycemia and excessive secretion of 17-ketosteroid and 17-hydrooxycorticoid. Although the patient had various clinical examination, the primary pathologic site was not found. It might be thought that the site is benign, since no general symptoms became worse during long course.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587241960組織培養による骨髄諸細胞の螢光顕微鏡学的研究 第3編 白血球の変性並に細胞機能と螢光との関係に関する研究 附.全編の総括11191132ENSusumuWatanabeBy performing the simple method of fluorochrominized bone marrow tissue culture the author observed the degeneration picture of leucccytes, and also studied changes in fluorescence in the cells cultured under an adverse condition but added with acridine orange. The following are the results of the present experiment. 1. It has been found that the majority of commonly-known findings by supravital staining are proven to be degeneration picture of cells. 2. As for the degeneration signs, the swelling and fading of reddish orange granules can be pointed out, while in cytoplasma vacuoles either stained or unstained with acridine orange, abnormal processes, the reddening or green swelling of cytoplasma can be recognized: The nuclei have agglutinated chromatin and have become yellow, red, and swollen in green color, and in nucleoles green swelling or reddening can be observed. 3. In the degeneration picture likewise each cell type present different fluorescence. 4. When cells become shrunk, the fluorescence is red, while when cells are swollen, it is green. 5. In the cells with decreased function reddish orange granules fade quickly and their nuclei turn yellow. 6. Those cells that have lost the fluorescence of their granules, and those that have red cytoplasma and red nuclei as well as those with their nuclei green and swollen as all-dead cells.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587241960組織培養による骨髄諸細胞の螢光顕微鏡学的研究 第2編 螢光培養法（Fluorochrominized Bone Marrow Tissue Culture）による正常人血液細胞の生態観察11071117ENSusumuWatanabeIn the present experiment the author conducted the bone marrow tissue of normal persons by the simple method of fluorochrominized bone marrow tissue culture as established in Report 1, and observed the growth zone and various bone marrow cells appearing in the zone. 1. The cells are dense in the central part of the growth zone, and the density gradually decreases towards the periphery, giving off reddish orange fluorescence diffusely with yellow and green fluorescent spots scattered in this zone. 2. Cytoplasma, is green, while mitochondria and various granules give off yellowish green or reddish orange fluorescence. However, the fluorescence of mitochondria is quite trivial, and the nuclei and nucleoles are green but nucleoles give off fluorescence earler than the nuclei. 3, In young cells green fluorescence of cytoplasma is marked, and it grows less distinct as they mature whereas reddish orange granules tend to increase along with the maturation of cells and their size is variegated. 4. In myelogenous cells reddish orange fluorescence of granules is characteristic while yellowish green fluorescence of the nuclei in lymphocytic cells. In mouocytic cells a variety of fluorescence such as green cytoplsama and reddish orange granules agglomerating around the nucleus can be recognized, and likewise fluorescence specific to each cell type can be observed in other cells. 5. The green fluorescence of cytoplasma of erythroblasts is gradually lost along with maturation, and no fluorescence can be recognized in erythrocytes, while substantia reticulofilamentosa of reticulocytes present red fluorescence. 6. When two barrier filters, GG 4 and OG 4 are used together, it is easy to differentiate cells of the erythroblast series from cells of the leucocyte series.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15587241960組織培養による骨髄諸細胞の螢光顕微鏡学的研究 第1編 螢光培養法（Fluorochrominized Bone Marrow Tissue Culture）に関する基礎的実験10971106ENSusumuWatanabeOf late many investigators have come to study blood cells with fluorescence microscope, but most of these works are carried out by supravital staining method only. Therefore, the author has attempted vital observations of bone marrow cells under the fluorescence microscope by adding fluorescent dye, acridine orange, to the medium of the simple tissue culture, the method devised in our department. For this study some fundamental studies have been conducted concerning the toxicity of dye, the selection of barrier filters, the secondary fluorescence of cells, and the influence of exciting rays on the cell growth; and obtained the following results. 1. After studying the relative growth rate, the cell density index, and the wandering velocity of neutrophils it has been found that. tissue culture is possible at low concentration, under 10(-4) of the medium with acridine orange. 2. Barrier filter, OG5 , is the most suitable one for the observation of the secondary fluorescence of the cell. 3. The concentration of the acridine orange medium at which the most distinct picture of fluorescence obtainable is at 10(-4) , and the concentration at 10(-5) is the minimum at which fluorescence can be recognized. 4. The ill effect on cells due to exciting rays may be eliminated by avoiding successive exposure to the rays. 5. The author has devised a medium for the bone marrow tissue culture, consisted of a drop of serum and a drop of physiological saline solution containing 80 γ / cc vitamin B(12) and 0.2 mg / cc acridine orange, and has designated this as the simple method of fluorochrominized bone marrow tissue culture.No potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama200612006奥付ENMamoruWatanabeHidenoriTachibanaNo potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama200612006万葉集の秋山39ENMamoruWatanabeNo potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama200612006はじめに1ENMamoruWatanabeNo potential conflict of interest relevant to this article was reported.岡山大学文学部Acta Medica Okayama200612006目次ENMamoruWatanabeHidenoriTachibanaNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15588211-121970甲状腺腫瘍のシンチグラムについて503509ENMasatadaTanabeKatsuhikoSugitaYasuoMorinoSetsuoWatanabeYoshioHaisaYasumasaKumadaPossiblity of differential diagnosis by means of the scintigram of thyroid gland was investigated with 15 cases with chronic inflammation, 54 with benign tumor, 22 with malignant tumor as the subjects of the study. The results are briefly summarized as follows. 1) In chronic inflammatory diseases most cases show an irregularity of the color band, and the lesion site is mostly located in the upper pole followed by the lower pole. 2) In cases of benign tumor warm nodules are decidedly predominant as compared with other diseases, and the margin is mostly either sharp or diffuse, especially sharp one in benign tumor than in malignant one. The peripheral contour is mostly concave. Enlargement of the lesion area is more often observed than in other diseases, and this tendency is especially marked in warm nodule. There can be often observed oppressive deformation. There is no difference of the color level between the right and the left sides. Lesion site does not differ from the right to the left side and it is mostly on the right exterior side and the left lower pole. 3) In malignant tumor, most cases show a large lesion. Ones with irregular margin are more numerous than in other diseases, but here it requires differentiation from inflammation. There is no swelling on the sideof lesion. The oppressive deformity is not so frequent as in benign cases. The affected side in most cases shows a lower color level as compared with healthy side. The lesion site in this case is mostly located in the upper pole.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558793-41967X線照射後家兎肝不飽和脂肪酸の抗癌作用 第2編 CBA系マウス腫水型白血病株について附,成熟家兎末梢血液に及ぼす影響について219226ENTerutuguWatanabeAnti-tumor activity of OX substance was studied in the lymphatic ascites leukemia in CBA mice, induved by successive trantation of ascitescell of DBA mice. Same investigations mentioned in the previous paper were carried out and following conclusions were obtained. 1) Administration of OX substance gave arise prevention of anemia and suppression of develpment of leukemia in DBA mice with ascites leukemia. 2) OX substance gave no influence to changes of the body weiht of DBA mice with ascites leukemia 3) Life span of DBA mica was remarkably prolonged by OX substance administration. 4) OX substance inhibited the infiltration of leukemia cells in the lung, liver, speen and other organs of DBA mice. 5) OX substance schowed the strong cytotoxic effect on the ascites leukemia cells in DBA mice. 6) OX substance gave no influence to the blood picture of the normal rabbit.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558793-41967X線照射後家兎肝不飽和脂肪酸の抗癌作用 第1編 DBA系マウス腹水型白血病株について211217ENTerutuguWatanabeAanti-tumor activity of OX substance, an unsaturated fatty acid extracted from rabbit liver 24 hours after 3,000γ irradiation, was studied in lymphatic asites leukemia in methyl cholanthren induced DBA mice. OX substance was administered intravenoulsy from the tail vein of mice. Red blood cell and white blood cell count of the peripheral blood, character of ascites and morphalogical changes of ascites cells, pathalogical findings of the visceral organs, body weight and survival period of mice were observed and following results were obtained. 1) Administration of OX substance gave arise prevention of anemia and suppression of development of leukemia in DBA mice with ascites leukemia. 2) OX substance gave no influence to changes of the body weight of DBA mice with
acites leukemia. 3) Life span of DBA mice was remarkably prolonged by OX substance administration. 4) OX substance inhibited the infiltration of leukemia cells in the lung, liver, spleen and other organs of DBA mice. 5) OX substznce schowed the strong cytotoxic effect on the ascites leukemia cells in DBA mice.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558825-61970膵臓結石症のレ線学的考察249255ENMichioYamamotoMasatadaTanabeKanameAonoYasumasaKumadaYasuoMorinoSetsuoWatanabeThe diagnosis of disseminated parapancreatic calculus is relatively easy from its specific roentgenogram, but in those cases with little roentgenographic shadow or with a solitary shadow it becomes quite difficult. Hence in the latter cases it is necessary to distinguish it from bilestone, kidney stone, peritoneal calcified lymph node, splenic venous thrombus, or duodenal diverticulosis. Therefore, for the diagnosis of the parapancreatic calculus it is important to take a single roentgenogram of the entire abdomen as well as lateral views of the abdomen, the combination of which would afford us to identify the parapancreatic calculus from the density of its shadow, its site and its size. We have recently encountered three patients with pancreatic calculus and present our observations of the cases as well as some remarks on them from the aspects of roentgenology.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558863-41974食道平滑筋腫の1例133138ENYasuoMorinoSetsuoWatanabeHisaoTakagiKazuhikoEbaraToyosatoTamaiMasatadaTanabeSosukeIidaKanziFujiwaraYoshioHaisaLeiomyoma of the esophagus is a rare lesion. On this case that we reported, the right oblique chest radiogram showed the soft tissue mass in the mediastinum. The diagnosis was made by the barium swallow study. In this report, we chiefly discussed about the radiologic findings of the esophageal leiomyoma and differential diagnosis with extraesophageal tumors.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15588311-121971心膜憩室に合併せる粘液腫の一症例について531536ENMichioYamamotoKanameAonoMasatadaTanabeYasuoMorinoSetsuoWatanabeKazuhikoEbaraDisease exhibiting an abnormal tumorous shadow on the pericardium in x-ray picture is rare, and that with pericardial cyst is still more scarce. Having encountered a case, suspected of pericardial cyst, which on surgical operation proved to be of pericardial diveaticle accompanied by myxoma, we presented details of our findings on this very rare case.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15588311-121971胃前庭部攣縮に対する考察523529ENMichioYamamotoKanameAonoYasuoMorinoSetsuoWatanabeSosukeIidaKanjiFujiwaraIn our routine X-ray examinations of the stomach we do no longer encounter much difficulty in the diagnosis of the case. By virtue of a marked improvement of the X-ray instruments as well as by a great advance in techniques of the diagnosis we now can use endoscope, fibrinoscope, cytological examinations among others that our diagnosis is betting more and more accurate, as revealed by many reports. Nonetheless, the difficulty we encounter in our X-ray diagnosis is in those cases with contracture or deformation in the pyloric antrum. Of course, in the cases with malignant pathological changes or ulcers, we face relatively less problems, but in those cases with various pathological changes on the mucous coat such as an irregular relief, a partial hypertropy or lacking in any definite finding, we find it difficult to decide whether such changes have been elicited by gastritis or other causes. We discussed about how we might handle when we meet such cases with contracture of the pyloric antrum.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558853-41973ラット臓器の脂質過酸化反応におよぼす放射線照射の影響 第3編 放射線照射ラツト各臓器の脂質過酸化物形成能に及ぼす放射線防護物質投与(in vivo)の影響について145150ENSetsuoWatanabeEffects of tathione and cepharanthin, the radiation-protective agents, on the lipid peroxidation in rat organs were studied, and obtained the results as follows. (1) The acceleration of lipid peroxide formation induced by X-irradiation can be inhibited by the administration of tathione prior to the irradiation and by the dose administered. Such an inhibitory effect is especially marked in the liver, and as reported in Part T and Part U, in view of correlations among X-irradiation effect, lipid peroxidation and fatty acid composition in the liver, it seems that glutathione in vivo is somehow involved in the acceleration of lipid peroxidation. (2) The increase of lipid content observable in the liver of X-irradiated animal could not be observed in the animals administered with tathione. (3) Cepharanthin showed not any relation to the lipid peroxidation.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558853-41973ラット臓器の脂質過酸化反応におよぼす放射線照射の影響 第2編 放射線照射ラット臓器における脂質過酸化反応と脂肪酸構成比の変動について137143ENSetsuoWatanabeWith four groups of rats, normal, irradiated, fasting, and irradiated-then-fasting rats (dose of X-ray, 650R), 48 hours afterwards, liver, heart, spleen and kidney were examined separately as to changes in the acceleration of lipid peroxidation and fatty acids due to irradiation were examined and obtained the results as follows. (1) The lipid peroxidation in each organ was accelerated after irradiation when compared to that in the organs of normal group. In the fasting group the acceleration of lipid peroxidation was observed, but the acceleration in the irradiated group was far more marked, indicating clearly the effect of irradiation. (2) As to changes in the ratio of fatty acid composition in every organ of the irradiated group there were observed an increase in the ratio of high unsaturated fatty acids and a decrease in the ratio of saturated fatty acids as compared with the respective values in normal group. Among organs there could be recognized no uniform change in the fasting group and the irradiated-then-fasting group. These results indicate that the fasting affects the ratio of fatty acid composition, especially marked was change in triglyceride fraction. (3) The lipid content in the liver tends to increase after irradiation, and there is also observed an incrase in the ratio of lipids to phospholipids. (4) The arachidonic acid of phospholipid what is considered to be substrate of lipid peroxidation is increased in the irradiated group, suggesting its relation to the acceleration of lipid peroxidation accompanying irradiation, and actually, the arachidonic acid ratio of phospholipid is markedly decreased after the incubation of lipid peroxidation reaction in the presence of Fe(++), indicating that this substance can play the role of substrate.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558853-41973ラット臓器の脂質過酸化反応におよぼす放射線照射の影響 第1編 放射線全身照射ラット臓器の脂質過酸化物形成能について129136ENSetsuoWatanabeAfter the whole body X-irradiation (650R) of rats, the lipid peroxide formation of various organs were estimated by the TBA reaction, and the results are presented as follows: (1) In TBA reaction tests on the lipid peroxidation in the liver, heart, spleen and kidney with homogenates being incubated, the TBA value were slightly high with endogenous homogenates, but on the addition of Fe(++) the reaction was further accelerated markedly. With liver and kidney that showed a high reaction on addition of Fe(++), the reaction was similarly accelerated on addition of ascorbic acid, but with heart and spleen the reaction at initial stage did not show any significant difference from that of the group without any addition. (2) In every organ from the irradiated animal the activity of lipid peroxide formation was greater than that in organs from non-irradiated control animals. (3) TBA value in the group added with Fe(++) were higher than those in the group without any addition, suggesting that X-irradiation greatly the lipid peroxidation in organs. (4) Change in the acceleration of lipid peroxidation accompanying the irradiation appears as a shortening of reaction-induction time. (5) Radioactivity-dose dependent change can be observed only in the liver, and the time-lapse change after irradiation can also observed only in the liver. (6) These results suggest that the lipid peroxidation following the whole body X-irradiation shows a significant change primarily in the liver.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558923-41980肝性脳症慢性型を呈する肝硬変症にみられた頭蓋内出血の1剖検例455461ENAkiharuWatanabeMasakiIzumiShigekiMizutaniToshitakeFujiiMasahiroWatanabeToshihiroHigashiHidekiYoshidaHiroshiEndoHideoNagashimaBloody cerebrospinal fluid indicated that the neuropsychiatric abnormalities observed in a cirrhotic patient with a chronic type of hepatic encephalopathy were due to intracranial vascular lesions. Autopsy findings revealed hemorrhagic infarction at the left frontal pole and subarachinoideal bleeding at the occipital lobe. It is particularly important to realize that abnormal mental states occurring in patients with cirrhosis of the liver may be due to many other conditions leading to coma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558921-21980四塩化炭素肝障害ラットにおける1-(2-Tetrahydrofuryl)-5-fluorouracilの血中消失速度定数に及ぼす還元型グルタチオンとビタミンEの影響267271ENNorioHobaraAkiharuWatanabeHideoNagashimaThe pharmacokinetics of 1-(2-tetrahydrofuryl)-5-fluorouracil (FT) were analysed by measuring its disappearance rate (K) from the circulating blood using a high-pressure liquid chromatographic technique. An increase in the disappearance rate of FT was observed by treatment with reduced glutathione (GSH)- or tocopheryl nicotinate-treated rats. The clearance rates of FT from the circulating blood in carbon tetrachloride (CCl(4))-injured rats were much smaller than those in untreated rats. The unresponsiveness of K values to treatment with GSH or tocopheryl nicotinate was seen in liver-injured rats.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558921-21980若年性胃ポリポーシスの1家系―知見補遺195204ENAkiharuWatanabeHideoNagashimaInnumerable juvenile polyps were recognised in the stomach of an 18-year-old girl. The clinical and pathological observations of the propositus have been already reported (in "Japanese Journal of Gastroenterology" and "Gastroenterology"). Her elder brother underwent a subtotal gastrectomy because of gastric polyposis at 14 years of age. Supplementary data of their clinical findings are given. They had no extragastric polyps on roentgenographic and endoscopic studies. A classification of this hereditary syndrome as a newly designated entity, juvenile polyposis of the stomach was proposed. Both siblings are now in good health.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558947-81982複製型および非複製型SV40クロマチン蛋白質の解析729734ENMinoruIrisawaTakashiNakamuraSekikoWatanabeTakuzoOdaSimian virus 40 (SV40) chromatin and mature virion were extracted from formaldehyde-fixed SV40-infected CV-1 cells. Mature virion was eliminated from SV40 chromatin by sucrose density gradient centrifugation. Replicating and nonreplicating SV40 chromatin were separated on CsCl/ guanidine-HCl density gradients. Replicating SV40 chromatin was lower in density than the nonreplicating form. The analysis of chromatin proteins by polyacrylamide gel electrophoresis and silver staining revealed that replicating chromatin has less H1 histone than the nonreplicating form.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2009流体方程式の基本解ENTakeshiWatanabeNo 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.岡山医学会Acta Medica Okayama0030-15589511-121983劇症肝炎の予後判別の検討13411345ENMasachikaFujiwaraAkiharuWatanabeHarushigeNakatsukasaTetsuyaShiotaTatsuroSakataNobuyukiTakeiMichioKobayashiHideoNagashimaAssessment of the prognosis of fulminant hepatitis was made from clinical findings at the time of the appearance of hepatic encephalopathy using five living and ten fatal cases of fulminant hepatitis. Those patients who died tended to be old, especially in the subacute type of fulminant hepatitis, and frequently had disseminated intravascular coagulation. Prognosis scoring by assessing clinical findings in these patients was calculated during their clinical courses. From differences in scores, the treatment performed following the occurrence of hepatic encephalopathy was judged to be effective in some of the surviving patients. Other patients died, however, because of the difficulty of sufficiently controlling complications. The prognosis scoring at the time of the appearance of encephalopathy was valid for female patients who survived. Clinical evaluation of this scoring method will be further evaluated with more cases in the future.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558957-81983SV40感染細胞分離核におけるSV40クロマチンのDNA複製と細胞質分画及びヒストンの効果815822ENYoshioMakiHiromichiIwamotoSachikoOmuraSekikoWatanabeTakuzoOdaSimian virds 40 (SV40) has a relatively simple and well defined genome, and is particularly appropriate as a model for studying mammalian chromatin. A nuclear system was developed for studying in vitro replication of SV40 chromatin, and the effects of cytoplasmic fractions obtained from uninfected CV-1 cells and calf thymus histones on the DNA replication were examined. The major polymerase involved in the replicative DNA synthesis was DNA polymerase α. Product analysis of replicated DNA showed that the amounts of the replicating intermediates and the open circular form of SV40 DNA (Form II) increased by in vitro DNA synthesis conducted without the addition of cytoplasmic fractions. By the addition of cytoplasmic fractions, the twisted form of SV40 DNA (Form I) as well as its replicative form and Form II were synthesized. Replicative DNA synthesis was inhibited by the addition of histone Hl but not by the addition of core histones, when the nuclear DNA to added hiatone ratio was similar to the DNA-histone ratio in eukaryotic chromatin.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558957-81983大腸癌患者における癌特異的免疫能に関する研究611621ENTetsuoWatanabeWe studied the correlation of a microcytotoxicity assay (MCA) and a 3H-Uridine postlabeling lymphocytoxicity assay (TPLA). Cells of the P-4788 cell line established from the pleuritis carcinomatosa of a colon cancer patient were used as the target cells. MCA correlated well with TPLA. The cytotoxicity index in the case of P-4788 cells as the target cells was high in comparison with the cytotoxicity index when M-Hela cells, a cell line from a uterine carcinoma, were used. A mixed lymphocyte tumor reaction with allo-antigen extracted from colon cancer was done, and the stimulation index of colon cancer patients was found to be high in comparison with that of gastric cancer patients and benign disease patients. There was no significant difference between the cytotoxicity of each stage of cancer before operation. However, there were significant differences the cytotoxicity before that after operation in all stages except stage V. There was a tendency for the blocking index to increase with the advance of cancer. Serum carcinoembryonic antigen (CEA) values increased with the advance of cancer and decreased after operation in all stages. Serum CEA values correlated with the blocking index, but not with the cytotoxicity index.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558955-61983頭頸部癌の再建外科・術式及び成績395403ENShuichiWatanabeRhusukeSaitoToshiakiOgawaraYoshioOguraMakotoKanataniYuzuruMatsubaraSatoshiKoikeVarious surgery techniques performed on 26 advanced cancer patients using forehead, deltopectoral(D-P) and musculocutaneous(M-C) flaps were reviwed. The D-P flap presents few cosmetic problems in the head and neck region and can be used in elder patients because of little operative invasion. The M-C flap allows for reconstruction of defects in a one-stage operation which may shorten hospitalization and permit an ealier return to social life. The forehead flap is the most durable and reliable flap among them for reconstructive surgery, though it offers some cosmetic problems. In reconstruction of the esophagus after a pharyngolaryngoesophagectomy for cancer of the hypopharynx and the cervical esophagus, it seems more advantageous to use a hige flap in reconstruction than Bakamjian's original method since early detection of a local recurrence of the tumor is rendered easier with the former. There were no fatal postoperative complication, though minor necrosis, fistula, suture insufficiency and esophageal stenosis were observed, but improved with conservative treatment. Conseqently, the reliability and versatility of pedicle and muculocutaneous flaps were confirmed. As to the prognosis, the 2-year survival rate was 42.2% . The cause of death was local recurrence in 4 patients, who all died within two years, and distant metastasis in 4 patients, who all died within one year of the operation. Local recurrence and distant metastasis were also seen in 4 patients who survived.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558963-41984聴器扁平上皮癌の臨床と側頭骨病理組織所見263270ENRyusukeSaitoAkikoFujimotoAkiraFujitaShuichiWatanabeTakaoTomotsuKeizoMisakiYoshioOguraKiyoshiMatsubaraSeven cases of squamous cell carcinoma of the ear encountered at Okayama university hospital between 1972 and 1981 were reviewed, and a histopathological study of the temporal bone of one patient was reported. All cases were in advanced stages, T3 in five cases and T4 in two cases according to the TNM classification of ear cancer after Sakai. The external auditory canal was the primary site in five cases and the middle ear in two cases. Only two patients, whose lesions were localized in the shallow portion of the external auditory canal, had lived for a long period without any recurrence at the time of this study. In contrast, the remaining five patients whose lesions extended into the middle ear and mastoid had died of cancer. Histopathological examination of the temporal bone of one patient revealed that the tumor extended both into the internal acoustic meatus along the facial canal and to the extratemporal bone area via the eustachian tube. Additionally, in spite of extensive osteoradionecrosis over the temporal bone due to a full dose of irradiation, active tumor tissue remained in the petrous apex cells of the temporal bone.From these findings, it was assumed that carcinoma of the ear is the most difficult to treat successfully among head and neck malignancies.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985モノクローナル抗体を用いた肺癌組織浸潤リンパ球の研究761775ENTetsuyaWatanabeSubsets of the infiltrating lymphocytes in lung cancer tissues of 64 patients were identified by immunohistochemical staining (ABC method) using monoclonal antibodies (Leu 2a, Leu 3a+b, Leu 4, Leu 7 and Leu 14). T cells were predominant in lung cencer tissues, and tended to infiltrate into cancer cell nests and stoma, diffusely and focally. On the contrary, B cells in most cases were observed to infiltrate focally apart from cancer cells. There was a significant reverse correlation between the intensity of the T cell infiltration and the tumor T factors, and also between Th/i cell infiltration and the tumor T factors. Th/i cells were more prominent in lung cancer than Ts/c cells, and Ts/c cells scarcely infiltrated. NK, K cells also infiltrated scarcely and sparsely, and there was no correlation between the intensity of NK, K infiltration and the clinical condition. It was concluded that immunohistochemical examination of infiltrating lymphocyte subsets in lung cancer can reveal direct local immune responses and may be a useful method for making prognoses.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985ヒト肺癌実験モデルの作製に関する研究 第2編 ヒト肺扁平上皮癌細胞株(EBC-1株)およびヒト肺腺癌細胞株(ABC-1株)の異種移植701712ENYoichiWatanabeTwo continuous cell lines, which were designated as EBC-1 and ABC-1, were recently established from explant cultures of human squamous cell carcinoma and adenocarcinoma of the lung in our laboratory. In the present study, for the purpose of making an animal model of human lung cancer, cells of EBC-1 and ABC-1 were transplanted into antilymphocyte serum (ALS)-treated newborn hamsters and into nude mice. The EBC-1 line was serially transplanted for 10 passages into ALS-treated newborn hamsters. When 0.75-24.0×10(5) cells were inoculated intraperitoneally or subcutaneously, 36 of 38 experimental animals developed invasive tumors 19-35 days after implantation. Metastases to the lungs were observed in 28 of 36 hamsters with tumors. The EBC-1 line was also transplantable to nude mice, but the tumor growth was very slow and serial transplantation was not successful. The ABC-1 line was transplantable to ALS-treated newborn hamsters, but propagated for only two passages. When 4.0-14.0×10(5) cells were inoculated intraperitoneally or subcutaneously, 14 of 20 experimental animals developed invasive tumors 28-33 days after implantation. The ABC-1 line was transplantable, but not serially transplantable to nude mice. In conclusion, EBC-1 when implanted into hamsters was a good model of human lung cancer. To my knowledge, this is the first report of a high frequency of lung metastases in the heterotransplantation of human lung cancer. This animal model should be useful for various studies of human lung cancer including mechanism of metastasis and chemosensitivity of anticancer agents.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558977-81985ヒト肺癌実験モデルの作製に関する研究 第1編 ヒト肺扁平上皮癌細胞株(EBC-1株)およびヒト肺腺癌細胞株(ABC-1株)の樹立とその性状691700ENYoichiWatanabeTwo human lung cancer cell lines designated as EBC-1 and ABC-1 were newly established for the purpose of making an in vitro experimental model of human lung cancer. The EBC-1 line was established from a metastatic skin tumor of a patient with squamous cell carcinoma of the lung. The cells grew in a monolayered sheet with a population-doubling time of 42 hr. The chromosome number showed wide variation from 35 to 102 with a modal peak at 53. The ABC-1 line was established from pleural effusion of a patient with adenocarcinoma of the lung. The cells grew mainly in a floating clump with a population-doubling time of 72 hr. Karyotypic analysis disclosed a wide variation from 25 to 57 with two modal peaks at 53 and 54. The EBC-1 and ABC-1 lines may be useful for biological, cytopharmacological and therapeutic studies of human squamous cell carcinoma and adenocarcinoma of the lung.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558999-101987ピクロトキシン投与後におけるラットの海馬領域の電子顕微鏡的・統計学的研究11011116ENHirokiWatanabeChanges in the granule cells of the rat dentate gyrus, hippocampal mossy fibers and moosy fiber boutons following administration of picrotoxin were examined at the ultrastructual level. In controls, many small round clear vesicles (20-40 nm in diameter) along with a small number of large dense-core vesicles (60-90 nm in diameter) filled the mossy fiber boutons. Following administration of picrotoxin, the large dense-core vesicles increased in number and accumulated on the presynaptic membrane. Some of the large dense-core vesicles appeared to be fused with the membrane and frequently exhibited omega-shaped exocytotic profiles. A greatly increased number of coated vesicles (60-90 nm in diameter) was observed on the maturing face of the Golgi fields in the cytoplasm of granule cells after injection of picrotoxin. In addition, the ends of the Golgi cisternae rods occasionally appeared to be coated, and coated large dense-core vesicles (60-80 nm in diameter) were seen in the mossy fibers. This study showed not only an increased incidence of large dense-core vesicle exocytosis during seizures, but also suggests that these vesicles are replaced in excess from the perikaryon.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558993-41987大学生の肥満と脂肪肝に関する疫学的研究347356ENKunitakeWatanabeAn epidemiological study of the relationship between obesity and fatty liver of students in Japan was performed. Measurements of subcutaneous fatty tissue (Nagamine's method) and body weight (according to the Ministry of Health and Welfare 1971-standard body weight method and 1986-standard body weight method) were used to determine obesity. The data of 6,485 18-year-old male and female students of Okayama University, obtained from records beginning 30 years ago, and the data of 1,932 students, obtained in 1986, were examined. The frequency of obesity of men increased since the nineteen-seventies (10.8% in 1986), but that of women did not change for the past 30 years. However, the frequency of emaciation of women has increased for the past 5-6 years (11.5-10.0%). Male students with negative HBs-antigen, higher GPT levels than GOT levels with one or both levels being abnormal, and high choline-esterase level (△ pH over 1.10) were suspected of having fatty liver, and many of them (85.7% by Nagamine's method, 66.7% by 1971-standard body weight method and 71.4% by 1986-method) were diagnosed as being obese. The students with fatty liver (judged by echography) had a greater frequency of obesity (86.7% by Nagamine's method, 80.0% by 1971-method and 76.7% by 1986-method) than those without fatty liver. The measurement of subcutaneous fatty tissue (Nagamine's method) was useful for screening fatty liver in students.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558993-41987コレステロール胆石症に対する内科的溶解療法の検討 ―治療による胆汁中胆汁酸分画の分析も含めて239250ENJun-ichiWatanabeEighty-three patients with cholesterol gallstones in a functioning gallbladder were treated with 400mg UDCA and 200mg CDCA (group A), 300mg UDCA and 300mg CDCA (group B), 200mg UDCA and 400mg CDCA (group C), 400mg CDCA alone (group D), 400mg CDCA and 240mg trihydroxy propiophenone (group E), or 600mg UDCA alone (group F). All patients were followed by cholecystography and ultrasonography. At the end of 6 months of treatment, the cumulative efficacy (complete plus partial dissolution) of all subjects were 41.0%. Twelve patients (14.5%) had complete dissolution. Group B had the highest dissolution rate (69.2%:38.5% complete and 30.7% partial dissolution), and this rate was significantly higher (p<0.01) than that of the CDCA-treated patients (group D). Diarrhea was frequently observed in patients treated with 400mg CDCA (27.8% in group D and 31.3% in group E). Combination with UDCA seemed to prevent this complication. No significant changes in the plasma lipids were observed. Changes in the bile acid composition, including lithocholic acid, did not seem to be determined solely by the doses of UDCA and CDCA. Patients whose lithogenic index dropped below 1.0 during the treatment did not always show dissolution of gallstones. Although the age of the patients, obesity and stone size did not affect the dissolution rate, the female sex and good gallbladder contractility were preferable factors for the dissolution of cholesterol gallstones.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558991-21987肝と免疫複合体：血中免疫複合体の肝への集積と肝細胞傷害性についての実験的研究169178ENMasahiroWatanabeIt was studied whether IgG-immune complexes were taken up by liver parenchymal cells and whether liver injury was induced by the immune complexes. When asialoorosomucoid, orosomucoid and human serum albumin immune complexes at various antigen-antibody ratios were infused into the portal vein of rats, the antibody-excess immune complexes were partly taken up by liver parenchymal cells via the asialoglycoprotein receptor. However, liver injury was not caused by the immune complexes. These observations suggest that 1) immune complexes at certain antigen-antibody ratios bind to the asialogycoprotein receptor, 2) immune complexes bound to the asialoglycoprotein receptor do not activate the complement system and 3) a transient increase in plasma immune complexes does not induce liver injury.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581001-21988胃癌患者における胃組織カテプシンBとL活性 ―病理学的所見との関連性―8995ENMasatomoWatanabeCathepsin B and L activities in cancer tissue and non-cancerous mucosal tissue were determined with small amounts of tissue homogenate from 29 operated patients with gastric cancer. Both enzyme activities were significantly higher in cancer tissues than in noncancerous mucosal tissues. The level of cathepsin B activity was higher in specimens of poorly differentiated adenocarcinomas, deeply invaded ps (+) and extensively metastasized regional lymph nodes (n(2) or n(3)) than in specimens of tubular adenocarcinomas, invaded ps (-) and no metastasized regional lymph nodes. No significant correlation was observed between the elevated levels of cathepsin L activity in cancer tissues and any of the histological findings. These results suggest a close relationship of this enzyme to local invasion and metastasis to regional lymph nodes.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-1558991-21987高分子GOT血症を呈した2症例4956ENKatashiMatsubaraAkiharuWatanabeToshihiroHigashiKazuoTobeHideoNagashimaThe first case of macromolecular GOT was reported by lida et al. in 1973, and since then only 11 cases have been reported. In the present paper, we report two cases of abnormally elevated serum GOT, which was difficult to explain by organic disorders. Using various biochemical and immunological methods, the GOT was concluded to be macromolecular GOT. Sephadex G-100 column chromatography was carried out to estimate the molecular size. After dividing the GOT into isoenzymes by Cellogel membrane electrophoresis, the GOTs were dyed using the GLDH method developed by Lippe. The immunofixation method was used to examine what kind of immunogloblin combined with GOT. Case 1 was a 69-year-old woman with angina pectoris and hypertension. Her serum GOT level was 279 IU/l. Her serum GOT was found to be combined with IgG-x. Case 2 was an 8-year-old boy who suffered from bronchial asthma. His serum GOT levels were highly elevated (192IU/L). The GOT was combined with IgG-λ. In both cases, we estimated the GOT molecular weight to be 14,0000 Daltons.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 Okayama0917-4494811997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移植された腎臓と医療に不満を抱く腎移植者6事例の分析17ENYoshikoNakanishiYukoHayashiNaomiKanaoKumiWatanabeEikoHoshina10.18926/15248これまで､腎移植者のQOLの向上をめざした系統的アプローチを看護援助モデルを基に検討してきた｡そして現在､腎移植者に対する効果的かつ具体的な看護介入について検討を進めている｡本研究では､移植された腎臓と受けている医療に不満を抱く腎移植者6名の事例分析を基に､腎移植者への看護的関わりを検討した｡その結果､この6名の移植者が抱く不満は､身体状態､責任を果す能力と周囲のサポート､自己実現と人生観､仕事と経済的自立､家族との関係の5つのカテゴリーに分類された｡そして､6名に共通する不満は､身体状態の問題に起因した健康に対してであった｡また､生体腎移植者はすべて家族に対する役割や他人に対する社会的役割の達成について不満を抱いていた｡そして､男性の移植者は､周囲からのサポートに満足していなかった｡これらのことは､腎移植者のQOL向上に向けた看護介入を具体化する上で最も考慮すべき要点であることが明らかとなった｡No potential conflict of interest relevant to this article was reported.岡山大学医学部保健学科Acta Medica Okayama1345-09481612005局所筋機能測定のための筋内挿入型プローブの開発18ENHisaoOkaMotonariEdamatsuShogoWatanabeTomokiKitawaki10.18926/15177臨床においては,筋機能や機能不全を診断するために,表面筋電図や針筋電図,筋生検などが行われている｡しかし,これらの方法では筋機能や筋収縮メカニズムを連続的に測定することは難しい｡本研究では新たに筋内挿入型プローブと測定システムを開発した｡測定プローブは光ファイバと6本の白金細線から構成されている｡光ファイバを用いて筋の局所血流量と筋内圧力を測定し,6個の電極を用いて運動単位活動電位を測定した｡プローブと測定システムの基礎特性を確認した後,麻酔下のラットの排腹筋において,安静時および局所虚血時の活動電位,血流量,筋内圧力を測定した｡また脛骨神経を電気刺激し,活動電位波形から伝播速度を算出したところ,プローブは正常に動作していることが確認できた｡さらに筋小胞体からのカルシウム放出チャネルを抑制するdantroleneを筋注すると,筋内圧力波形は大きく減少したが,活動電位波形はほとんど変化しないことがわかった｡No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581023-41990頑痛の発生および抑制に関する基礎的・臨床的研究 第1編 三叉神経脊髄路尾側亜核におけるサブスタンス P およびエンケファリン濃度変動の意義に関する基礎的研究287297ENNoriakiFujiwaraThe possible role of substance P (SP) and enkephalin (ENK) was investigated in the mechanism of deafferented pain (DP) and excess pain. The concentration of SP anf ENK was quantitatively estimated with radioimmunoassay using 17 adults cats. The animal were divided into 3 group, DP group (8 cats), EP group (6 cats) and untreated conrol group (3 cats). The DP group was prepared according to the method described by Shimizu and EP model was made by injection 1 ml of Freund's adjuvant subcutaneously into the unilateral face of the cats every day for 3 weeks. The amount of SP in STN markedly decreased in DP group and significantly higher in EP group than with the control group. This is explained by the fact that SP is a neurotransmitter for pain of trigeminal nerve. No significant decrease in ENK in the DP group was observed. This suggests that ENK in STN is not always controlled by the descending inhibitory system, but may be working in the propriospinal system. ENK in the EP group also showed no significant increase. This can be explained not only by the difficulty in estimating the rapid degeneration of ENK, but also by the strong participation of monoamines as well as ENK in pain relief. The role of ENK should not be overstimated and the studies including monoamines will be necessary to detemine the mechanism of pain.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990ヒトアデノウィルス12型誘発腫瘍におけるE1領域遺伝子の組み込みと発現143152ENTomokoMorikawaIntegration and expression of human adenovirus type 12 (Ad12) were studied on two Ad12-induced tumor lines of C3Hf/OK mouse origin (IC and D tumors). Southern hybridization using whole Ad12 genome as probe demonstrated that DNA of IC and D tumors contained about 9 and 23 copies, respectively, of the entire Ad12 genome eqivalent per diploid cell. Left ends of Ad12 DNA appeared as off-size bands, indicating their linkage to different cellular DNAs. Southern hybridization using and Ad12 EcoRI-C fragment containing the E1 region as a probe revealed that intergration sites were much fewer than presumen numbers of integrated Ad12 genones. These results suggested that the viral and cellular DNA complex was repeated at integration sites. Northen hybridization using an Ad12 EcoRI-C fragment as a probe showed that tha E1 region was transcribed in both IC and D tumors. Much more intensive expression in the D tumor suggested possible dependence of the expression of the E1 region on the copy numbers of Ad12 genomes.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990Pringle 法急性肝流入血行遮断の肺血管外水分量におよぼす影響 第2編 上腸間膜動脈遮断と門脈一体循環シャント造設の効果を中心として7786ENNobujiYokoyamaTo elucidate the effect of portal congestion on pulmonary interstitial edema after temporary hepatic ischemia by Pringle's maneuver, extravascular lung water (EVLW) was experimentally measured using a modified double indicator dilution method before and after interruption of the hepatic blood flow follwing clamping of the superior meaenteric artery or portofemoral vein bypass. The following results were obtained. 1) Compred with clamping of the superior mesenteric artery, the portofemoral vein bypass reduced the increase of EVLW after temporay hepatic ischemia by Pringle's maneuver. 2) The increase in EVLW had a tendency to be influenced by the degree of metabolic acidosis and portal congestion. These findngs suggest that the portofemoral vein bypass is more effective in the prolongation of the safe period of temporary hepatic ischemia by Pringle's maneuver than clamping of the superior mesenteric artery.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810311-121991光硬化性樹脂プレポリマーを用いる脱窒菌の固定化に関する研究12151224ENTsutomuItadaniThe denitrifiers isolated from the activated sludge of night soil treatment plant were immobilized using a photo-crosslinkable resin prepolymer. Denitrifying activity was strongly inhibited during the first period but the activity was increased in the medium containing nitrate and recovered after 1 day. Acetate was an effective hydrogen source and soap was also effective. Methanol could not serve as a hydrogen source. The optimum pH for denitrification by the immobilized bacteria was 7.0 for nitrite and 7.5 for nitrate, and the optimum temperature ranged 30℃ to 40℃. The lowest CH3COONa/NOx-N ratio nessary for getting the highest activity was 4 for nitrite (BOD/NO2-N＝2) and 5 for nitrate (BOD/NO3-N＝2.5). Photo-crosslinkable resin prepolymer gels exhibited stable denitrification activity to the secondarily treated sewage contained 70mg/l of soap.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810311-121991固定化活性汚泥を用いる排水処理実験12071214ENTsutomuItadaniYosikazuHiraiYasuhiroKanemasaEikoNagamachiActivated sludge obtained from the night soil treatment plant was immobilized using acrylamide and nitrification and the BOD removal of the sewage were studied by using the immobilized activated sludge which was packed in a single treatment tank. The findings indicated that the ratio of nitrification in the immobilized gel tank was larger than that in the free activated sludge tank in every operation period, and the rate of BOD removal in the immobilized gel tank was roughly equal to that in the free activated sludge tank in this condition. The findings indicated that the application of immobilized activated sludge to the sewage treatment enabled the sewage treatment process to be more efficiency and compact.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990Pringle 法急性肝流入血行遮断の肺血管外水分量におよぼす影響 第1編 肺血管外水分量の増加とその成因を中心として6376ENNobujiYokoyamaTo elucidate the effect of total hepatic ischemia on pulmonary organs, extravascular lung water (EVLW) was experimentally measured using a modified double indicator dilution method before and after interruption of the hepatic blood flow using Pringle's maneuver. The follow-ing results were obtained : 1) EVLW was significantlly increased more than one hour after temporary total hepatic ischemia. 2) Temporary hypotension resulted in little increase of EVLW by removing and replacing some blood volume through the femoral artery. 3) Pumonary interstitial edema was histologically and maroscopically observed in the Pringle's maneuver group. 4) Marked metabolic acidosis and elevation of serum transaminase were revealed after temporary hepatic ischemia. These findings auggest that pulmonary interstitial edema may result from sfter temporary total hepatic ischemia by Pringle's maneuver and the changes of EVLW are caused by increased permeability due to liver injury, metabolic acidosis and portal congestion.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991過敏性肺臓炎の病態に関する研究 第2編 過敏性肺臓炎患者における沈降抗体に関する検討349358ENKohMakimotoThe presence of percipitating antibodies has been recognized to be essential for the diagnosis of hypersensitivity pneumonitis, although the mechanism of this antibody formation is still obscure. Precipitating antibodies were examined in patients with various respiratory disease including hypersensitivity pneumonitis. Patients with hypersensitivity pneumonitis had more precipitating antibodies than patients with bronchial asthma, PIE syndrome and other fibrotic lung diseases. Furthermore, asymptomatic family members of patients with hypersensitivity pneumonitis living in the same environment were shown to have few precipitating antibodies as a normal control. The presence of polluted air containing an antigen such as fungi is nescessary but not enough for the antibody formation. These findings suggest that the high responsiveness of the immune system of the respiratory tract would be important as well as the existance of contaminated air for the pathogenesis of hypersensitivity pneumonitis.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581021-21990小児における下部食道内pH動態の研究―24時間食道内pH monitoring による解析―722ENYasuhiroWatanabeTwenty-four-hour esohageal pH monitoring in infants and children has been performed to clarify pH dynamics of the lower esophagus using a pH histogram and acid clearance value in addition to pH score. A pH histogram showing the total state of pH dynamics in the lower esophagus ia constructed with whole pH data obtained by 24-hour pH monitoring. An acid clearance value indication the clearance ability of the esophagus is calculated by pH curves. 1) The normal acid clearance value is under 100. 2) Lower-side-tail of the pH histograms has been analyzed with an acid clearance value and other parameters of gastric acid reflux into the esophagus. Several characteristic pH dynamics are observed in cases of apparently normal patterns and mild gastroesophageal reflux (GER) which were diagnosed by a conventional manner : (a) moderate reflux with good clearance ability, (b) prolonged running status between pH 3 and 4, and (c) mild and pathological reflux with impaired clearance cbility. 3) pH histograms of the GER type are divided into 2 subtypes : The flattened subtype, which indicates ture GER with incompetence of the lower esophageal sphincter (LES), and the peaked subtype, which is often observed in cases of hypertrophic pyloric stenosis and has a well-functioning LES without pathologic GER.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991イヌの完全全脳虚血後の脳障害に及ぼすSMA-SOD の効果に関する実験的研究257266ENYoshimasaTakedaThe effects of stylene maleinic acid butyl ester superoxide dismutase (SMA-SOD) on the brain damage induced by ischemia were studied in dogs. Eighteen minutes of cerebral ischemia was produced by clamping the ascending aorta with aorta-atrial and aorta-femoral vein bypass circuit. SMA-SOD(10mg/kg) was administered just after the initiation of recirculation. Dogs were divided into, control group and SMA-SOD group. In each group, cerebral blood flow (CBF) and intracranial pressure (ICP) were measured for 7 hours after ischemia, and neurologic outcome was evaluated up to 7 days after ischemia. Furthermore, extravasation of evans blue dye (EB, 100mg/kg) were observed 30 minutes after ischemia. SMA-SOD increased CBF during the hyperemia, and improved both delayed post-ischemic hypoperfusion (DHP) and neurologic outcomes. Extravasation of EB were recognized in the control group, but not in the SMA-SOD group.
In conclusion, vasogenic edema might play a role in the elevation of ICP besides the hyperemia, and SMA-SOD improved neurologic outcome by prevention of edema, and improvement of DHP. Furthermore, free radicals might play a role in the appearance of ischemic brain damage.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810341991Biotin 標識 probe を用いた histo in situ hydridization 法による胃癌組織における癌遺伝子 mRNA の検討247255ENIzuruTanakaExpression of oncogene mRNA in gastric cancer was studied by in situ hybridization. Cancer tissues were fixed in formalin and embeded in paraffin. Then, DNA-mRNA hybridization was performed by using two biotin-labeled cDNA probes (c-myc, c-Ha ras).
Oncogene mRNA was intracuelularly localized, mainly in the cytoplasm, and also found in the nucleus of partial cells. Higher concentrations of oncogene mRNA vere found in advanced cancers than in early cancers, and in metastatic positive cases of the above n2 than of n0 or n1.
This suggests that the expression of oncogene mRNA is related to the malignant potency of cancer.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581031-21991脳血管攣縮の発生機序と治療に関する実験的研究 第2編 実験的遅発性脳血管攣縮に対する PGI2 analogue, Thromboxane A2 合成酵素阻害剤, Ca 拮抗剤の効果183197ENMototsuguMotokiThe effects of a PGI2 analogue (OP-41483), a thromboxane A2 synthetase inhibitor (OKY-046) and a Ca blocker (nifedipine) on the diameter of constricted basilar arteries and on the regional cerebral blood flow (r-CBF) in the brain stem were investigated in the cat delayed spasm model. The experiment was performed three days (72 hours) after artificial subarachnoid hemorrhage. The basilar artery was exposed transclivally, and more advanced vasospasm was produced by topical application of a lysed erythrocyte solution for 5 to 6 hours which domonstrated no more vascular dilatation even by topical application of papaverine hydrochloride (0.01mg/ml). In the delayed spasm model, the intravenous administration of neither OP-41483 (8μg/kg), OKY-046 (60mg/kg) nor nifedipine (0.003mg/kg) affected the vascular diameter. OP-41483 increased r-CBF in the brain stem in 3, and nifedipine increased it in 4 out of the 5 studied delayed spasm models, whereas OKY-046 never increased r-CBF (n=5). There was no significant difference in the amount of fatty acids including arachidonic acid between normal and constricted arteries. This study suggested that thromboxane A2 is not the major factor of cerebral vasospasm and OKY-046 might not be effective on vascular diameter or r-CBF at the late spasm stage. However, the PGI2 analogue (OP-41483) and Ca blocker (nifedipine) may be effective in increasing r-CBF even at the late spasm stage.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 Okayama0030-15581045-61992子宮体癌に対する超音波断層法の有用性について―経腹走査と経腟走査の比較を中心に―501510ENHirotakaTomokuniBetween April, 1986 and March, 1991, 60 patients who underwent surgical treatment for endometrial carcinoma at the Department of Obstetrics and Gynecology, Okayama University Hospital, were preperatively examined by transvaginal ultrasonography (TV) and trans-abdominal ultrasonography (TA). The findings obtained were compared with the pathological findings to determine their usefulness in evaluating myometrial invasion and cervical invasion of endometrial carcinoma. Sensitvity of the lesion was 98.3% by TV and 80.0% by TA (p<0.01). Accuracy of the presence of myometrial invasion was 88.3% by TV and 70.0% by TA. Moreover, in evaluating the depth of myometrial invasion in three degrees (MO : Tumor limited to endometrium, M1 : Invasion to<1/2 myometrium, and M2 : Invasion >1/2 myometrium), the accuracy was 85.0% by TV and 61.7% by TA (p<0.01). In regard to the minimum width of the intact myometrium and the thickness of the high echoic area measured by each method, significant differences were obserevd between the M2-group and the other two group by the two methods. These p-values in TV were more significant than those in TA. In evaluating the presence of cervical invasion, the accuray was 95.0% by TV, while 88.3% by TA. Thus TV was found to be more useful than TA in the evaluation of both myometrial invasion and cerical invasion.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581031-21991右冠動脈反応性充血の検討―左冠動脈との比較―7784ENHirofumiWatanabeFlow reserve of the right coronary artery (RCA) was studied in open-chest dogs and compared with that of the left anterior descending coronary artery (LAD). The maximum percent peak reactive hyperemia (％PRH) of the RCA was greater, and the duration of occlusion that produced one-half of the maximum coronary vasodilation (T1/2) in the RCA was about twice that in the LAD. With an increase in right ventricular MVO2 produced by construction of pulmonary artery or isoproterenol infusion, T1/2 of the RCA was shortened significantly. For estimating the quantitative contribution of the perfusion pressure to coronary flow reserve, we occluded the RCA for 60 sec and the LAD for 30 sec, during which each vessel reached maximum vasodilation with various perfusion pressure in the range of 100 to 20 mmHg. ％PRH decreased with a reduction in perfusion pressure, and perfusion pressure below which the RH abolished was significantly lower in the RCA than the LAD : 32.2±5.7 VS 41.5±5.0 mmHg. Thus, the RCA has a greater flow reserve than the LAD, and lower cardiac work and less extravascular artery compression of the right ventricle would account for this finding.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581045-61992子宮体癌に対する経腟走査超音波断層法とMRIの有用性について―筋層浸潤と頚部浸潤の評価―489499ENEisukeYoshiharaBetween October, 1988 and March, 1991, twenty-mine patients with endometrial carcinoma bad both transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI) performed following hysterectomy at the Departmetn of Gynecology and Obstetrics, Okayama University Medical School. The findings were compared with the pathological findings to determine the usefulness of each method. The sensitivity of dectecthing myometrial invasion was 100% by TVUS and 96% by MRI. The accuracy was 86% by each method. The depth of myometrial invasion was classified into 3 degrees [no myometrial invasion, superficial invasion (≤1/2), deep invasion (>1/2)]. The correct diagnostic rate was 86% by TVUS and MRI. The minimum width and the minimum/maximum width ratio of the intact myometrium obtained by each method in the pathological deep invasion group were significantly lower than those obtained in the other two groups (p<0.01). The sensitivity, the accuracy and the specificity of detecting cervical invasion were 89%, 93% and 95% by both methods. There was no difference between TVUS and MRI for diagnosing myometrial and cerical invasion of endometrial carcinoma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581037-81991右側結腸癌に対するリンパ節郭清範囲の検討10131018ENHiromiIwagakiAkioHizutaFumihiroHamadaShigeoShiikiNagahideMatsubaraYoshihiroAkazaiKiichiSuzakiTetsuyaWatanabeYasuyukiNonakaToshikazuKimuraSadanoriFuchimotoKunzoOritaThe lymph node metastases of the right side colon were studied. Among 58 cases of right side colon, nodal involvements were found in 53.4%. Metastases to the epicolic and paracolic nodes were confined to an area within 10 cm from the tumor margin. Metastases to the intermediate nodes were found in 20.7% and metastases to the main nodes in 15.5%. Jumping metastases were recognized in 5 out of 31 cases of nodal involvement (16.1%). As the rate of jumping metastases is unexpectedly high, lymph node dissection for right colon cancer should be done as far as the main nodes.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581037-81991三歳児健康診査の評価―検尿の意義と判定方法―983992ENKatsukoTanakaThis study focuses on the health examination programs for 3 year old children from a public health point of view. The methodology, items tested, criteria and follow-up systems of urine examination were evaluated. Results of urine examinations of 8,615 children(male : 4,490, female : 4,125), who had been in the health examination program from 1980 to 1985, were studied in the area of K-ku in Y-city. Moreover a follow-up study was performed to discuss the significance of urine examination as mass screening. In the health examination program for 3 year old children, it is efficient to classify those with a score of more than “one plus” into the high risk group with regard to proteinuria and hematuria. It is possible to reduce the false positive rate by checking first morning urine at re-examination. A bettr information net work system must be established to utilize the results of mass health examinations for three year old children.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581043-41992血小板凝集能の個体差を考慮した至適抗血小板療法―心臓血管外科手術後遠隔期における検討―341354ENYoshimasaTsushimaPlatelet aggregation was studied on 670 samples of 20 healthy controls and 279 patients in the late period after cardiovascular surgery. Aggregating agents used were 0.5 and 2.0μM ADP as well as 2mM arachidonic acid (AA). Among the healthy controls, a maximum aggregation rate over 18% (ADP 0.5μM) was considered hyperaggregability, those under 47% (ADP 2μM) or under 78% (AA 2mM) consid-ered hypoaggregability. Maximun aggregation rate in patients not given antiplatelt agents widely varied from hyperaggregability to hypoaggregability. There was a positive correlation botween the first sample and the second one gained from each patient. This suggested that individual variation existed on platelet aggregation. Maximum aggregation rate significatly decreased by ticlopidine for ADP and by aspirin for AA. Both ADP and AA should be used for platelet aggregation. Comparison among three groups of different ticlopidine doses revealed that the doses should be decided on the basis of platelet aggregation for each patient. Thrombotic or hemorrhagic complications were observed in only 9 cases. Four of 7 cases of thrombotic complicatiion showed hyperaggregability and only 1 case showed hypoaggregability. Both cases of hemorrhagic complication showed hypoaggregability. These findings suggest that indication for antiplatelet therapy and doses of antiplatelet agent should be decided in consideration of individual variation on platelet aggregation.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581037-81991直腸絨毛腺腫の4例―本邦報告88例についての検討―945949ENNagahideMatsubaraSadanoriFuchimotoHiromiIwagakiToshihiroOokuraYoshihiroAkazaiTetsuyaWatanabeKiichiSuzakiHiroshiYamashitaFumihiroHamadaAkiraGouchiAkioHizutaKunzoOritaWe reviewed the charts of 4 patients with villous adenoma of the rectum seen at the First Dept. of Surg., Okayama Univ. Med. School between 1971 and 1990. This study included 2 men and 2 women, ranging in age from 52 to 83 years. Polypectomy was performed on 3 patients with villous adenoma and low anterior resection was performed on 1 patient. Recurrent tumors developed in one of the 3 patients who had undergone polypectomy. In addition, a series of 88 patients with villous adenoma of the rectum reported in Japan were also reviewed. The average age of the patients with villous adenoma was 62.9. There were 47 men and 41 women. The presenting symptoms of the 69 patients with tumor were mainly bleeding and watery or mucinous diarrhea. The tumor size and invasiveness of malignancy were also examined. The likelihood of malignancy correlated with size of tumor, and none of the lesions smaller than 2cm contained a malignant tumor site. Surgeons should consider the size, location and malignant change of the villous tumor with as much precise examination before and during operation so that unnecessary over surgery is avoided.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 Okayama1346-3705612006A research on students knowledge, awareness and interest about environmental issues ; a case study at a high school in Japan2132ENJulius KofiAgubekoEtsuyoNasuTomomiKasaiToshioWatanebeKazukoEdagawaMasakazuKita10.18926/14352Education for Sustainable Development(ESD)-Environmental Education, has been a major concern at most UN summits. The 2002 Johannesburg Summit broadened the vision and re-affirmed the objective of the Millennium evelopment Goals (MDS) and proclaimed the Decade of Education for Sustainable Development for the period 2005-2014. This emphasized that education, is critical for promoting sustainable development and improving capacity of the people to address environment and development issues. This paper seeks to report, a finding on the level of student awareness and interests in environmental issues at a High School in Japan (a Super Science High School). A curricula unit was developed in the area of environmental education on soil. An actual chemistry class has been conducted in English. Pre & post lesson questionnaires were administered to the students. The result of the analysis indicates that, students are aware of environmental issues but need to be exposed to these issues in the form of activity-based classroom lessons. This we believe, will enable the students appreciate the fact that ESD is a life-wide and lifelong endeavor which challenges individuals, institutions and societies to view tomorrow as a day that belongs to all of us. This we presume is the main challenge of the MDS.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581043-41992インターフェロン並びにインターフェロン誘発剤に関する基礎的・臨床的研究 第1編 インターフェロン並びにインターフェロン誘発剤の好中球 Chemiluminescence に及ぼす影響247258ENMitsuhiroFukumotoTo evaluate one the effects of interferon (IFN) and its inducers on neutrophil functions neutrophil chemiluminescence (ChL) was assayed on 31 healthy individuals, nine patients treated with IFN-α (human lymphoblastoid interferon, 3×10(6)units/day i. m. daily) and 11 patients treated with Ge-132 (2,250mg/day p. o. daily). The base lines (BLs), peak levels (PLs) and times to PLs (PLs) of neutrophil ChL were examined before, one week and one month after the treatment. The direct effects of IFN-α, Ge-132 and OK-432 on neutrophil ChL were also evaluated by using an in vitro experimental system. PLs were significantly increased one week after the treatment with IFN-α or Ge-132. However, they were decreased to the pretreatment level one month after the treatment. In vitro experimental system IFN-α enhanced PLs of neutrophil ChL showing dose and time dependencies. On the other hand Ge-132 and OK-432 showed no direct effect on neutrophil ChL in vitro. These findings suggest that IFN-α and Ge-132 enhance the host defense mechanism by the activation of neutrophil functions, and also suggest that they have some benefits not only in the clinical management of cancer but also of chronic infection.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama2008Dual-Tyrosine Kinase Inhibitor for Focal Adhesion Kinase and Insulin-like Growth Factor-I Receptor Exhibits Anticancer Effect in Esophageal Adenocarcinoma In vitro and In vivoENNobuyukiWatanabeNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581043-41992肝再生に及ぼす Cyclosporin A の影響241246ENHiroshiYamamotoWhen lymphokine activiated killer cells (LAK cell) induced by IL-2 are infused into the same strain C(3)H mice following 70% partial hepatectomy, they display an action to suppress liver regeneration. Therefore, when Cyclosporin A (CsA) which inhibits IL-2 production was administerd to mice following partial hepatectomy, we studied as our indicator the labeling index of hepatic parenchyma cells using Brdu. Our findings showed that proliferation of live cells at 36 hours following partial hepatectomy was promoted by CsA, and the streongest promotion occuring at a dose of 5mg/kg. Before anf after hepatectomy when CsA was administered at 10mg/kg for 3 dadys, a further strong proliferation increasing effect was observed, and under these conditions at 48 and 60 hours after hepatectomy a significant increase in liver weight was observed. Give the above results, CsA it thought to have a promoting effect in liver regeneration following hepatectomy.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810411-121992モノアミン代謝酵素活性に及ぼすグアニジノ化合物の影響に関する研究10931105ENKatsuhisaHukuyamaIn the central nervous system (CNS)of mammals, monoamine oxidase (EC 1.4.3.4)(MAO), which have been divided into two functional forms (MAO-A and MAO-B), and catechol-O-methyltransferase (EC 2.1.1.6)(COMT) act as catabolic enzymes of catecholamines and serotonin regulating their concentrations. In this study, the effects of guanidino compounds (5mM) on MAO-A, MAO-B and COMT were examined to invastigate the role of guanidino compounds in CNS function. MAO-A activity was decreased by α-guanidinoglutaric acid (GGA) and guanidinoethanesulfonic acid, and increased by arginine (Arg) and N-acetylarginine at a low substrate concentration (4.33μM). MAO-B activity was decreased by creatinine (CRN), δ-guanidinovaleric acid (GVA) and methylguanidine (MGua) at a high substrate concentration (3.125mM), and decreased by CRN, GVA, MGua, Arg, guanidine, 2-guanidinoethanol, β-guanidinopropionic acid, guanidinosuccinic acid and homoarginine at a low substrate concentration (62.5μM). GVA, CRN and MGua acted as competitive inhibitors on MAO-B and their calculated Ki values were 9.47mM, 14.5mM and 29.4mM, respectively. Although the guanidino compounds tested had no effect on COMT activity at a high substrate concentration (600μM), GSA and GVA inhibited COMT activity at a low substrate concentration (75μM). These results suggest that some guanidino compounds influence catabolic enzymes of indoleamine and catecholamines to control CNS function.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581041-21992心臓弁膜症のMR画像診断支援システムの開発とその臨床応用に関する研究187194ENTomioNakagawaMRI is a valuable tool for diagnosing heart disease today. The cardiac blood flow is determined by an MRI image analysis and expert system. Image data are taken by a TV camera and digitalized. After gray level thresholding and region segmentation, the boundary of the regurgitant flow region is precisely extracted. Using this expert system, a doctor can easily make an accurate diagnosis of the valvular heart disease. This method should prove useful for the diagnosis of various heart diseases.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581041-21992肺切除術における術後心肺合併症発生予測のための指数設定及びその臨床的有用性の検討165176ENYuichiKobashiTwo indicators (Risk score and Resection Index) for pulmonary and cardiac complications after lung resection were evaluated on 182 patients with bronchogenic carcinoma by quantita-tive technetium 99m macroaggregation albumin (MAA) perfusion scanning preoperatively and who then underwent lung resection. After surgerg, the correlations between preoperative lung function and the development of postoperative pulmonary and cardiac complications (PPCC) were examined in each case. The Risk score consisted of eight parameters (% FVC, FEV 1.0%, % MVV, % MMF, V50/HT, V25/HT, % peak flow, and % DLco), and a value of from 0 to 8 was assigned. In the patients with a Risk score of 0, PPCC occurred in 5 of the 71 cases, while complications were noted in 26 of the 94 patients with a Risk score from 1 to 5 and in 14 of the 17 patients with a score of over 6. The Resection Index was calculated from the predicted postoperative FEV 1.0 from the quantitative 99m Tc MAA perfusion scan and the predicted FEV 1.0, PPCC occurred in 20 of the 27 patients with a Resection Index of below 40%, 25 of the 131 patients with an index of 40% to 65%, and none of the 24 with an index over 65%. Both indicators had a good correlation with the occurrence of PPCC. These two indicators, the Risk score and the Resection Index, were clincally useful for predicting PPCC preoperatively and may help reduce the incidence of PPCC.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581041-21992レーザー光凝固による未熟児網膜症の治療に関する研究8395ENChiakiOhtakiForty eyes in twenty-two cases in the active phase of retinopathy of prematurity were treated with laser photocagulation. Thiry (93.7%) of the 32 eyes in type I and intermediate type were found in the cicartrical phase grade 1. In type U in which cryocautery was used as combination therapy, only 2 eyes (25.0%) were found in grade 1, 2 eyes (25.0%) in grade 2, 1 eye (12.5%) in grade 4 and 3 eyes (37.5%) in grade 5. All 21 eyes in which photocoagulation was performed up to the middle of stage 3 were found in grade 1 (100%). However, among 11 eyes in which photocoagulation were performed in late stage 3, 9 eys (81.8%) were found in grade 1, and 2 eyes (18.2%) in grade 2. In conclusion, if adequate laser photocoagulation is performed in avascular ares at the middle of stage 3 of type T and intermediate type, treatment in cicartrical phase grade 1 is possible. Laser photocoagulation is clearly more effective than the xenon are photocoagula-tion or cryocautery. However, in type U it is difficult to control the condition by photocagulation alone, and early diagnosis followed by combination therapy using cryocautery is reqired.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581037-81991教室における家族性大腸ポリポーシス症例の検討833839ENKazuhikoWatanabeHiromiIwagakiSadanoriFuchimotoShigeoShiikiNagahideMatubaraYoshihiroAkazaiTetsuyaWatanabeKiichiSuzakiFumihiroHamadaAkiraGouchiAkioHizutaKunzoOritaFamilial polyposis coli (FPC) is an inherited nonsex linked mendelian dominant disease in which there exist at least 100 adenomatous polyps throughout the entire large bowel. Thirteen patients with FPC, of whom 7 were male and 6 female, visited our department between 1966 and 1990. The mean age of the patients was 33.5. Eight of the 13 patients (61.5%) had gastric and/or duodenal polyps, and eight of the 13 patients (61.5%) had colorectal carcinomas at admission. Colectomy with ileorectal anastomosis (IRA) was performed on 2 patients. The functional results were good bowel frequency, good sphincter control and lack of dietary restriction. Clinical experience tended to suggest that the risk of rectal cancer following IRA is extreme and unacceptable, although our two cases were still free of rectal cancer. Since 1980, the total colectomy with mucosal proctectomy and ileal pouch-anal anastomosis was the procedure of choice in our department. Good results were obtained on the six patients on whom this procedure was performed.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581049-101992間接熱量測定による消化器手術後のエネルギー代謝の検討―投与量･投与経路の比較―885895ENKenYoshizaneMany studies have shown that enteral nutrition (EN) has nutritional effects comparable to total parenteral nutrition (TPN). However, the energy metabolism of the two different nutritioanl methods remains undefined. The two nutritional methods were compared by measuring the resting energy expenditure (REE) and nutritional assessment in postoperative patients after gastrointestinal surgery. The effects of different amounts of EN were also evaluated. Patients were diveded into three groups : Patients who were fed by EN of 30 Cal/kg/day (Group I, EN 30 : n=8), patients who were fed by EN of 40 Cal/kg/day (Group II, EN 40 : n=8), and patients who were fed by TPN of 30 Cal/kg/day (Group III, TPN : n=8). REE was measured by the Datex indirect calorimetry and nutritional assessment included the measurements of triceps skinfold thickness (TSF), arm muscle circumference (AMC), albumin and rapid turnover proteins. ％REE/BEE of EN30, EN40 and TPN was 122.5±14.3%, 138.2±16.8% and 107.6±10.5% respectively. The RQ for the three groups was about 1.0, which means the energy source of all regimens is carbohydrate. The TPN group showed a significantly higher RQ than the EN groups, but there was no difference in albumin or transferrin. There was no difference in nutritional effect between EN 30 and EN 40. No difference was found in anthropometric effects among the three groups. These findings suggest that 30 Cal/kg/day would be preferable to 40 Cal/kg/day in energy supply of enteral nutrition and that the energy expenditure of EN is higher than that of TPN under 30 Cal/kg/day nutrition. There is no difference among the three mehtods in terms of nutritional effects.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581041-21992慢性関節リウマチ患者における大腿骨頸部骨折の臨床的ならびにX線学的研究6374ENMasahideKawamuraClinical and radiological studies were performed on 58 patients with rheumatoid arthritis (RA) who had sustained 64 femoral neck fractures. All but one patietns werre female, the mean age was 66.5 years, and mean duration of RA was 17 years. Only 3 hips showed rheumatoid changes. Sixteen fractures of 14 patietns were spontaneous fractures without trauma. Ipsilateral total knee replacements were performed on 5 patients with spontaneous fractures. Results of treatment were analyzed on 47 fractures in 43 patients that could be followed up for more than 1 year (mean 42 months). Clinical results were evaluated by ability of ambula-tion and complications such as nonunion and avascular necrosis of the femoral head. All 4 fractures treated conservatively and 5 of 9 displaced fractures treated by internal fixation developed complications. Femoral head replacements had a high rate of proximal migration (23.8%) and distal migration (76.2%), and ambulation ability was lowered significantly in 10 patients with distal migration for more than 5 mm. On the other hand, satisfactory results were obtained on all 6 fractures treated by total hip replacements (THR). THR is advisable for tratmetn of displaced femoral neck fracture in patients with RA.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581041-21992頭頸部癌の再建外科―当科における再建術式の臨床的観察―2938ENShuichiWatanabeTakashiKawakamiIkuoInokuchiKin-yaUnoTakuyaOhomichiMotoharuFukazawaTakaakiYonedaKunihiroFukushimaYuMasudaYasuakiKamikawaThiry nine reconstructive surgeries were performed in 37 cases of head and neck cancers from January, 1989 to August, 1991 in our department. The best functional results were obtained on deglutition, swallowing and phonatin after intraoral and/or mesopharyngeal reconstruction using free radial forearm flaps. The free jejunal transposition procedure had the lowest complication rate. The rectus abdominus musculocutaneous free flap was used for nasal, paranasal reconstruction. Esthetics could be presereved by this reconstruction method due to mider postoperative atrophy and contraction. Eye sockets for the artificial eyes were made with eye conjunctiva in 3 canses of extended total maxillectomy with the orbital exenteration. The use of microvas-cular free flaps in this new plastic surgery resulted in the decrease of refusal of operations in maxillectomy canses.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581041-21992ヌードマウス可移植性ヒト大腸癌細胞株 LoVoに対する interferon-α,-γ, tumor necrosis factor-α の抗腫瘍効果の検討2127ENKazuhikoKataokaYoshioNaomotoMasahikoMuroKazushiKojimaSadayukiHorikiAkioHizutaNoriakiTanakaKunzoOritaWe investigated the in vivo antitumor effect of recombinant human interferon-α,γ (IFN-α,γ) and/or recombinant human tumor necrosis factor-α (TNF-α) against human colon cancer cells (LoVo) transplanted into nude mice. LoVo cells were very sensitive to IFN-γ and slightly sensitive to IFN-α and resistant to TNF-α in vitro by dye uptake method. Intravenous administration of IFN-γ significantly inhibited tumor growth transplanted subcutaneously into nude mice, but IFN-α and/or TNF-α did not show any antitumor effect. Labeling index on stanining with bromodeoxyuridune and mitotic index of LoVo cells treated with IFN-α,γ or TNF-α differed slightly from those of the control group. We previously reported that the synergistic antitumor effects on the three cell lines could be examined by the combined use of IFN-α and TNF-α and the mechanism of the synergism was arrested in the S phase of cell cycle of target cells. However in the cese of LoVo cells, the combined use of IFN-α and TNF-α was not effective and did not arrest the cells in tha S phase of cell cycle. Therefore, arrest in the S phase was suspected to be responsible from the synergistic antitumor activity of IFN-α and TNF-α on the sensitive targets.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581065-61994腹腔動脈完全閉塞をきたした肝細胞癌合併高齢者糖尿病の興味ある一例663668ENTakahikoOkaJunTomodaHaruhikoKobashiNobuyukiSakaiKohsakuSakaguchiKazuhideYamamotoToshihiroHigashiToshioItoGotaroYamadaTakaoTsujiWe report a 75-year-old female with diabetes mellitus complicated with celiac arterial obliteration and hepatocellular cercinoma (HCC). She had been treated with diet therapy by her family doctor for essential hypertension and diabetes mellitus and was referred to our hospital because a space occupying lesion (SOL) was detected in the liver by abdominal CT examination. The SOL was confirmed as hepatocellular carcinoma by ultrasonography and magnetic resoance imaging. Celiac angiography revealed complete obliteration of the celiac artery probably due to diabetic macroangiopathy. Sine the deterioration of the liver function was not conspicuous, it was suggested that the development of HCC was affected by diabetes mellitus.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581065-61994腎性貧血に対するエリスロポエチンの維持投与法の検討655661ENTosioOguraYoshioNagakeHirofumiMakinoToshinoriHaramotoMitsuhitoMatsumotoMakotoHiramatsuYasuakiMinoShigeakiNishimuraKazuhiTaniaiIsaoKumagaiKiichiKomotoYoshiakiTakehisaUmeharuMatsuuraYoshihikoSugaZensukeOtaThe beneficial effect of recombinant human erythropoietin (EPO) for renal anemia in patients with chronic hemodialysis has been esthablishel. EPO is reported to be effective against renal anemia when adeministered at a dose 3,000 units three times a week. However, only a few studies have been made on the therapy to maintain the anemia-improving effect of EPO. In the present study, we performed EPO maintenance therapy on 22 hemodialysis patients with renal anemia. EPO was initialy administered at a dose of 3,000 units three times a week, and maintenance therapy was initiated after 12 weeks of treatment. The patients were divided into two groups, with EPO being administered at a dose of 1,500 units twice a week to one group and three times a week to the other. The duration of maintenance therapy was set at eight weeks. The anemia-improving effect of EPO was found to be satisfactorily maintained in both groups and no significant difference was noted between them. According, it may be better to use the lower dose regimen of 1,500 units twice a week for the maintenance therapy of renal anemia.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581047-81992高校野球選手における形態と投能力の関係789795ENHayatoUchidaThere is little information on anthropometric measures (i. e., length, breadth and girth of body's parts) related to throwing ability. To clarify the influence of the physique on the throwing ability, the relationships between physique and throwing distance, as well as ball speed were investigated. The subjects were fourty-nine high school baseball players, and thirty-eight high school volleyball players, football players and canoeists served as a control group. The throwing distance was significantly related to lean body mass (r=.290), chest girth (r=.416), upper arm girth (r=.307), abdominal girth (r=.288), thigh girth (r=.327) and lower leg girth (r=.285) in baseball players group (p<0.05-0.01). A significant relationship between the throwing distance and foot length in control group (r=.329, p<0.05) was demonstrated. Significant relationships between ball speed and standing height in the baseball players group (r=.354, p<0.01) and that between ball speed and Impedance in the control group (r=-.288, p<0.05) were ovserved. These findings indicate that the throwing distance is influenced by quantity of body muscle in baseball players. There was no relation between physique and throwing ability in unskilled players.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581047-81992実験的閉塞性黄疸および肝循環障害における血清と胸管リンパ液組成の変動に関する研究747761ENYuzoUedaA long-term study on the chemical and physiological changes of serum and thoracic-duct lymph in the dog with a ligated common bile duct and/or artificial liver circulation was performed. The influencee of ligation of the common bile duct appeared earlier in the thoracic-duct lymph than in the serum. The portal pressure did not increase in the dog with a ligated common bile duct, but the lymph flow of the thoracic duct was 3 times that before ligation, which would prevent the rapid stagnation of bile pigment in the liver. The portal pressure was not elevated after ligation of the hepatic artery. The cholesterol level in the thoracic-duct lymph was about half of that in the serum. In the dog with ligature of the common bile duct, the serum total cholesterol level was elevated with the elevation of serum bilirubin, whereas that in the lymph of the thoracic duct was not elevated with the elevation of the bilirubin level in the lymph. These findings suggested that cholesterol would not easily enter into the lymphatic route. The serum GPT level increased during the first week after ligation of the hepatic artery, and decreased thereafter. However, after ligation of the common bile duct, the GPT level increased for several weeks after the first week of ligation. The pattern of GPT by both ligations seemed to be cross-crossed. The marked change in the total bilirubin level in the lymph of the thoracic duct suggested its close relation with the lymphatic system. It was proved possible to secure a tube into the thoracic duct for over three weeks by the use of a U-type connector and jacket-type plaster cast.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581047-81992難治性喘息の病態と治療に関する研究 第2編 難治性喘息における細胞反応型アレルギーに対する選択的 Thromboxane A(2) 合成酵素阻害剤の抑制機序について735746ENArihikoKanehiroThe specific thromboxane A(2) (TXA(2)) synthetase inhibitor (OKY-046) seems to be a useful drug in the treatment of intractable asthmatics. In this study, to clarify the action mechanism of OKY-046 and the relationship between TXA(2) and prostaglandin E(2) (PGE(2)) in cell-mediated allergy, the effect of the TXA(2) receptor antagonist (AA-2414), TXA2 analogue (STA(2)) and PGE(2) for peripheral blood mononuclear cells in adult intractable asthmatics was studied. OKY-046 significantly suppressed TXB(2) production and increased PGE(2) production from the peripheral blood mononuclear cells stimulated by PHA and Candida antigen, but AA-2414 had no effect. AA-2414 suppressed lymphocyte blastgenesis, but did not suppress significantly interleukin-2 (IL-2) or neutrophil chemotactic factor (NCF) production. Furthermore, STA(2) increased lymphocyte blastgenesis stimulated by Candida antigen partially, but not dose-dependently. On the other hand, PGE(2) suppressed significantly lymphocyte blastgenesis and IL-2 and NCF production in a dose-dependent manner. These findings suggest that the action mechanism of OKY-046 is a suppressive effect of cell-mediated allergy, and that TXA(2) and PGE(2) play an important role in the mechanism of intractable asthma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581047-81992難治性喘息の病態と治療に関する研究 第1編 難治性喘息患者のリンパ球および好中球機能に及ぼす選択的 Thromboxane A(2) 合成酵素阻害剤の効果721733ENArihikoKanehiroTo clarify whether thromboxane A(2) (TXA(2)) is involved in type III and IV allergy, so-called "cell-mediated allergy", the effects of a specific TXA(2) synthetase inhibitor, sodium ozagrel (OKY-046) on peripheral blood mononuclear cells and neutrophils in adult intractable asthmatics were studied. Lymphocyte blastogenesis and interleukin-2 (IL-2) production from peripheral blood mononuclear cells stimulated by PHA and Candida antigen in intractable asthmatics was significantly suppressed dose-dependently by OKY-046. The neutrophil chemotactic factor (NCF) and eosinophil chemotactic factor (ECF) from peripheral blood nomonuclear cells stimulated by Candida antigen in intractable asthmatics tended to be suppressed by OKY-046. Furthermore, leukotriene C(4) (LTC(4)) and superoxide (O(2)(-)) production from peripheral blood neutrophils in intractable asthmatics was significantly suppressed dose-dependently by OKY-046. These findings suggest that TXA(2) plays an important role in the development of intractable asthma and OKY-046, which has a suppressive effect on type IV allergy caused by lymphocyte activation and on mediator release from neutrophils, might be a useful drug in the treatment of intractalbe asthmatics.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581055-61993無機フッ素の腎に及ぼす影響に関する実験的研究629639ENAtsuyaYamamotoIt was previously reported that the elevation of inorganic fluorine level in plasma after inkalation of methoxyflurane causes acute renal failure. This study investigated whether the peak concentration or the duration of the inorganic fluorine is responsible for the real failure. Continuous infusion (5 millimols/liter and 10 millimols/liter) or a single intravenous bolus injection (720 millimols/liter) of sodium fluoride solution was adminstered to rabbits. The plasma concentration and the duration of the plasma fluorine was measured. There were no signs of pathological or biochemical changes that suggested renal failure when the peak plasma concentration was less than 50 millimols/liter for over 4 hours (5 millimols/liter, 24 hours), or whether peak concentration of plasma inorganic fliorine was over 50 millimols/liter for less than 4 hours (720 millimols/liter, intravenous bolus). However when 10 millimols/liter of sodium fluoride solution was administered at a speed of 10 milliliters/hour for 24 hours, the rabbits showed a peak plasma inorganic fluorine concentration over 50 micromols/liter for more than 4 hours and signs of renal failure developed ata plasma concentration of 65.8 micromols/liter 24 hours after the beginning of infusion. renal failure was mainly inthe form of edema of the tubular cells in both the cortex and medulla and abnormal biochemical changes (blood urea nitrogen 55.8±12.5 milligrams/deciliter, plasma creatinine 1.2±0.1 milligrams/deciliter). Inorganic fluorine can cause renal changes when its paek plasma concentration reaches more than 50 micromols/liter and lasts for more than 4 hours.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581055-61993びまん性汎細気管支炎の病態に関する研究 第1編 びまん性汎細気管支炎患者の気道細胞反応611618ENTakamasaShiraishiDiffuse panbronchiolitis (DPB) is known as a chronic progressive inflammation of the peripheral airway followed by lethal respiratory failure. Bronchoalveolar lavage (BAL) was performed to clarify the pathogenesis of DPB compared to chronic bronchitis. The recovery rate of BAL fluid in DPB decreased, but total cell count increased enormously. Furthermore, increased proportions of neutrophils in BAL fluid from DPB patients was characteristic and included a relative decrease in alveolar macrophages. Patients with DPB were classified based on the presence or absence chronic airway infection with Pseudomonas aeruginosa. There was no significant difference in cellular components of BAL fluid among the patients with or without Pseudomonas infection. Patients with DPB showed both obstructive and restrictive ventilatory disturbances. There was no correlation between parameters of these respiratory functions and total cell counts or various cellular proportions in BAL fluid. Infiltrating cell density around bronchioles of patients with DBP was measured. Significantly higher cell density was shown in patinets with DPB compared to other disease controls. There were also significant negative correlations between cell density and respiratory parameters such as % vital capacity, % V50 and % V25. These results indicate that remarkable increase in neutrophils in BAL fluid and the marked cell infiltration around bronchioles in DPB patients could play a crucial role in the pathogenesis of DPB.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581037-81991教室における直腸癌側方リンパ節転移の検討741747ENHiromiIwagakiSadanoriFuchimotoFumihiroHamadaShigeoShiikiYoshimasaYasuiNagahideMatsubaraYoshihiroAkazaiTetsuyaWatanabeAkiraGouchiAkioHizutaYasuakiKamikawaKunzoOritaThe records of 182 consecutive rectal carcinomas treated in this department between JAN 1978 and DEC 1990 were reviewed to assess the outcome of the patients presenting with lateral pelvic lymph node infiltration. Lateral lymph node dissection was carried out in 24 (42.1%) of the 57 Ra tumors and 63 (72.4%) of the 87 Rb tumors, but in none of the 38 cases of Rs tumors. Lymph node involvement was detected 0% and 15.9% of the Ra and Rb tumors, respectively. In this series, none of the cases in which the tumors were confined to m, sm and pm had positive lymph nodes. However, 23.3% of the 43 cases in which invasion was beyond pm showed positive lymph node invasion. The main lymph nodes involved were located in the roots of the middle rectal arteries. Half of the patients presented with distant metastases within one year, with poorer prognosis considering the mean survival rate of 1.8 years. In conclusion, we advocate that in Rb rectal tumors with circular invasion or invasion beyond the pm, careful lateral lymph nede dissection should be carried out. On the other hand, we suggest the use of preoperative radiation therapy which could improve the curability, the disease-free interval, and survival rates.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581065-61994気管支喘息患者における減感作療法に作用機序に関する研究―抗原特異的IgGサブクラス抗体とロイコトリエン産生能に及ぼす影響について―539547ENSachieKatagiTo clarify the mechanism of immunotherapy in bronchial asthma, the level of mite specific IgG subclass asntibodies (total IgG, IgG(1), IgG(4)) and the production of leukotrienes (LTB(4), LTC(4)) released from leukocytes were examined. Eighteen mite-sensitive asthmatic patiens who received immunotherapy with house dust extract for 1 year were dividel into two groups, the responsive patients and non-responsive patients. Before treatment and 1 year after treatment, the levels of mite specific serum IgG subclass antibodies were measured by enzyme-linked immunosorbent assay (ELISA) and the levels of LTs were measured by high performance liquid chromatography (HPLC). In the responsive group, the level of mite specific serum IgG(4) antibody was significantly increased (p<0.05), and the level of mite specific serum total IgG and IgG(1) antibody was decreased. The release of LTB(4) and LTC(4) from leukocytes stimulated by mite antigen was significantly decreased (p<0.05,p<0.05).
These results indicate that increases in the antigen specific IgG(4) and the inhibiton of chemical madiators play important roles in the mechanism of immunotherapy.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155810511-121993悪性リンパ腫の化学療法に関する研究 第2編 血液腫瘍細胞に対する in vitro の薬剤併用効果：Median effect analysis による検討10191030ENKunioUenoTo establish an effective combination chemotherapy for hematologic malignancies, the combined effects of four anthracycline-anthraquinones and five other drugs were assessed in vitro. The anthracycline-anthraquinones were adriamycin (ADM), aclarubicin (ACR), THP-adriamycin (THP-ADM), mitoxantrone (MXT) and five other drugs were 4-hydroperoxycyclophosphamide (4HO(2)-CTX), cytarabine (Ara-C), vincristine (VCR), etoposide (ETP), cisplatin (CDDP). Median effect analysis presented by Chou and Talalay was used to assess the combined effects of these drugs on two cell lines (HL-60 and Raji). In addition, the ratio of maximal tolerable dose (MTD) to the dose that produced 50% growth inhibition (Dm) was calculated to estimate the clinical activity of each drug. Data of MTD/Dm indicated that THP-ADM and MXT might be clinically superior to ADM and ACR. The results of median effect analysis shown by a combination index were as follows : As to HL-60 cells that were derived from acute promyelocytic leukemia cells, synergistic effects were seen in the combination of ACR and Ara-C, THP-ADM and CDDP, MXT and 4HO2-CTX, MXT and Ara-C, MXT and VCR, MXT and ETP, indicating that MXT showed efficient synergistic effects when combined with other drugs. As to Raji cells that were derived from Burkitt's lymphoma cells, synergistic effects were observed in the combinations of ADM and ETP, ADM and CDDP, ACR and VCR,THP-ADM and VCR, THP-ADM and ETP, THP-ADM and CDDP, MXT and VCR, indicating that THP-ADM showed efficient synergistic effects when combined with other drugs.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581055-61993局所脳血流測定法による脳腫瘍の循環動態に関する研究527541ENShoheiTsuchidaRegional cerebral blood flow (rCBF) was measured with xenon-enhanced CT(Xe-CT) in 21 cases of intracranial tumors (13 meningiomas, 5 gliomas, 3 metastatic brain tumors). Peritumoral edema was graded as mild, moderate or severe based on the extent of edema on CT and MRI. According to intratumoral blood flow distribution patterns, three patterns were classified as central type with relatively high blood flow at the center of the tumor, homogeneous type with an almost homegeneous blood flow distribution, and marginal type with relatively high blood flow at the periphery of the tumor. High grade astrocytoma and metastatic brain tumor showed marginal type blood flow and moderate or severe edema except in one case. Five meningiomas with severe peritumoral edema revealed marginal type blood flow and four with mild peritumoral edema showed central type blood flow, except for one cace. No correlation was found between the extent of peritumoral edema and histological subtype, tumor size, locaton, duration of clinical history, vascularization on angiogram, and mean blood flow in the tumor. These results suggest that blood flow distribution patterns within the tumor may affect the extension of peritumoral edema. Pre-and postoperative rCBFs were evaluated with Xe-CT and IMP-SPECT in 7 cases. mean rCBF of peritumoral edema was 6.2ml/100g/min preoperatively, and discrepancy between rCBF on Xe-CT and that on IMP-SPECT was shown in the remote cortical region ipsilateral to the tumor. Postoperative rCBF revealed an improved blood flow in both adjacent and remote areas, suggesting that the decreased blood flow associated with brain tumors might be relieved after surgery.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581065-61994悪性リンパ腫の病態と治療に関する研究 第2編 悪性リンパ腫における natural killer 活性の検討505516ENShinyaTagawaThe natural killer (NK) activity of peripheral blood mononuclear cells (PBMC) from patients with malignant lymphoma was examined. In 54 untreated patients, the mean NK activity did not differ significantly from that in healthy controls. However, 17 (31%) of 54 patients showed low NK activity. NK activity did not correlate with the stage, histologic type or patient age. Significant reduction of NK activity was observed during combination chemo-therapy. The mean NK activity in complete respondors (CRs) did not differ significantly from that in healthy controls. However, 5 (14%) of 37 patients who were disease-free for more than 3 years showed low NK activity. Low NK activity was frequently observed in long-term CRs with non-Hodgkin's lymphoma compared with negative PPD skin test, negative PHA skin test, low CD4/CD8 ratio and decreased response of PBMC to PHA and/or Con A. These results indicate that patients with malignant lymphoma have decreased immunity even while in long-term continuous remission and that measuring NK activity is useful for evaluating their immunologic status.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581055-61993左室容量負荷弁膜疾患の弁置換術前後における左室拡張能と心筋微細構造との関係―心プールシンチグラフｨーによる検討―499512ENTomiroOkadaLeft ventricular (LV) diastolic functions in 23 patients with aortic regurgitation (AR) and 22 patients with mitral regurgitation (MR) were evaluated by gated pool scintigraphy. LV myocardial biopsy was performed during open heart surgery, and LV myocardial ultrastructural chasges were evaluated by electron microscope. Correlation between LV diastolic function and myocardial ultrastructural change was examined. It was suggested that preoperative LV diastolic dysfunction occurred earlier than LV systolic dysfunction in patients with AR and MR. LV early diastolic dysfunction was especially significant in patients with AR. LV systolic function was significantly improved postoperatively compared with LV diastolic function in patients with AR and MR. It was suggested that LV interstitial fibrosis caused LV diastolic dysfunction in patients with AR and MR, and insufficiency of myocardial thickening as compensation in patients with MR. It was presumed that LV diastolic dysfunction was irreversilble in patients with AR and MR in the distant postoperative period due to persistence of the preoporative myocardial ultrastructural change, e.g, interstitial fibrosis. these LV diastolic indices measured by gated pool scintigraphy were useful in predicting LV ultrastructural changes and postoperative LV dysfunction in patients with LV volumeoverloaded valvular heart disease.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581065-61994悪性リンパ腫の病態と治療に関する研究 第1編 悪性リンパ腫化学療法後の2次癌発症についての検討493503ENShinyaTagawaThe risk of a second malignancy was analyzed in 23 patients with Hodgkin's disease (HD) and 177 with non-Hodgkin's lymphoma (NHL) who were initially treated with combination chemotherapy between 1976 and 1990. Among these patients, 3 cases of gastric cancer, 2 cases of lung cancer, 2 cases of hepatoma, one case of colon cnacer, one case of cholangiocarcinoma and one case of acute myeloblastic leukemia were subsequently observed. Median age at diagnosis of lymphoma was 64 years in patients who developed subsequent malignancies but was 9 years higher than that for the entire lymphoma group. Median interval from srart of chemotherapy to the appearance of second malignancy was 43.9 years and ranged from 1.9 years to 8.8 years. The 7-year cumulative risk of second malignancy in HD and NHL were 7.7% and 11.7%, respectively. In Hodgkin's disease, the incidence of stomach and lung cancers was significantly greater than expected incidence calculated on the basis of age-adjusted person-years. In non-Hodgkin's lymphoma, the incidence was also greater than expected for all malignancies except stomach cancer. This indicater that the incidence of solid malignancy as well as leukemia is higher in lymphoma patients after chemotherapy than in the general population.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581055-61993結節性甲状腺腫の超音波診断における Enhancement 法の試み489498ENRyuzoTakeuchiEnhancement in thyroid ultrasonography was investigated with thyroid lymphography by injection of Lipiodol into thyroid nodules in 50 patients. On plain thyroid ultrasonography (PU), the echo levels of normal and tumorous portions of the thyroid glands were evaluated. Then, the echo level ratios (P-N/T) were calculated. Moreover, by the same method, the echo level ratios between normal and tumorous portions of the thyroid glands were culculated 6 hours after Lipiodol injection (E-N/T), when the greatest enhancement was anticipated. The mean value of P-N/T was 1.305, and that of E-N/T was 1.474. The echo level ratio was significantly elevated in the enhancement method (p<0.0014). We concluded that the enhancement is obtained with Lipiodol injection into the normal portion of the thyroid glands, regardless of whether the tumor is benign or malignant and with or without cystic degeneration. This method is useful in promoting quality and location diagnosis of thyroid nodules. N : echo level value in the normal portion of thyroid gland T : echo level value in the tumorous portion of thyroid gland N/T : echo level raitoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581055-61993非定型的白血病の病態並びに治療に関する研究 第2編 非定型的白血病の治療に関する検討：(4)N-behenoyl-1-β-D-arabinofuranosyl-cytosine(BHAC) 少量療法の臨床効果437445ENHiroshiNakadaTherapeutic effects of low-dose (4)N-Behenoyl-β-D-Arabinofuranosylcytosine(BHAC) on 52 patients with hypoplastic leukemia were analyzed to establish the optimal clinical management of hypoplastic leukemia. Among 8 patients treated with a low-dose (4)N-Behenoyl-β-D-Arabinofuranosyl cytosine (LD-BHAC) regimen, in which 50mg BHAC was administered daily intravenously by one-hour drip infusion for 14 days, 4 patients obtained complete remission (CR) and 2 patients obtained partial remission (PR). The response rate (CR+PR) was 75%. The responders were all over 65 years old. Although hematological toxicities and adverse effects on the digestive system such as anorexia and nausea were observed, they were all controllable by conventional treatments. The serum concentrations of ara-C were measured in 4 patients. Serum ara-C reached the peak concentration, 3.62-18.9 ng/ml (mean : 11.74 ng/ml), at the cessation of BHAC infusion, and a serum ara-C level of 2.75-4.89 ng/ml (mean : 3.54 ng/ml) was still present 6 hours after the cessation of infusion. Among 44 patients hospitalized before 1984, 27 patients were treated with blood transfusion and /or single antileukemic agent and 17 patients received combination chemotherapeutic regimens. Only 8 of 44 patients attained CR. The responders were all below 65 years old, and except for one patient, received combination chemotherapy. These results suggest that LD-BHAC therapy is useful in the clinical management of hypoplastic leukemia as a remission induction chemotherapy.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581063-41994気管支喘息における換気血流動態の研究―(133)Xe換気シンチ及び(99m)Tc-MAA血流シンチによる検討―415428ENHidenobuIshihamaTo clarify the organic changes and pathophysiology of the lungs in intractable asthmatics, the dynamic states of pulmonary ventilation and perfusion were analyzed in 15 bronchial asthmatic in the stable state using (133)Xe gas ventilation scintigraphy and (99m)Tc-MAA lung perfusion scintigraphy, respectively. Dysfunction of pulmonary ventilation and impairment of pulmonary perfusin were significantly severer in intractable asthmatics than in non-intractable asthmatics (p<0.01, P<0.05, respectively) and those of asthma caused by aging. Late onset asthmatics with a long duration of disease tended to show severe impairment of pulmonary perfusion. Above all the longer the duration of the disease the severer became the impairment of pulmonary perfusion in late onset intractable asthmatics (LOIA). These findings suggest that the progression of irreversible organic changes of lungs in LOIA is involved in the severity of brochial asthma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581063-41994レーザーサイトメーターを用いたheat shock protein 72の加温および抗癌剤添加による動態の検討401413ENHideakiSawaiHeat shock proteins (HSPs) are regarded as the proteins most related to the development of thermotolerance. Recently, not only their role in thermotolerance, but also their role in resistance to anticancer agents is gathering concern. In this study, the kinetics of hsp 72 in HeLa cells treated with heating and/or anticancer agents were studied. Hsp 72 was immuno-stained by the indirect fluorescent technique using a monoclonal anti-hsp 72 antibody (Amer-sham). The staining pattern was observed and analyzed using a laser cytometer, ACAS 570 (Meridian). Hsp 72 was normally found in the cytoplasm at 37℃ and moved rapidly into the nucleus with heating at 43℃ for 2 hours. It then returned to the cytoplasm 4 to 6 hours after heating. The hsp 72 content reached a peak at 8 hours after heating. Hsp 72 was induced in all cells treated with cisplation, adriamycin, peplomycin, or etoposide for 48 hours. In the cells treated with both heating at 43℃ for 2 hours and these anticancer agents, hsp 72 induction was most suppressed by adriamycin. However, translocation of hsp 72 to the nucleus was specific for heating and was not affected by the anticancer agents. By laser cytometry the intracellular localization of hsp 72 and the changes of its content were simultaneously detected, Moreover, the change pattern of hsp 72 content measured by laser cytomtry coincided with that measured by the Western blotting procedure.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581053-41993同所性肝移植の実験的研究 肝移植手術における血漿遊離アミノ酸の変動とその意義について303316ENTadakazuMatsudaTo determine the viability of livers after transplantation, three groups of experimental models were prepared (i. e., liver transplantation by the modified Starzl method ; hepatic cold-ischemia with cold ischemic time equal to transplantation time ; and simple laparotomy with sugar loading). Changes in plasma-free amino acid levels were investigated.
The results showed an elevation of total amino acid levels in the early stage of a viable liver transplant. In addition, a decrease in the molar ratio of branched chain amino acids and aromatic amino acids was observed during the rejection period. The results also confirmed an increase in ornithine level, NH3, and ornithine carbamyl transferase as well as a decrease in the citrulline level, and unchanged arginine. A disturbance in the reaction in the urea cycle during the second stage was considered the cause. Among the plasma amino acids, alanine showed the greatest increase during the rejection period. This might be attributed to an acceleration in alanine release in the periphery, and an abnormal glucose-alanime cycle.
As described above, examining changes in plasma-free amino acid levels may be an effective index of the viability of a liver transplant, both in the early stage and during the rejection poriod.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581063-41994難治性喘息の治療に関する研究 第2編 モルモット喘息モデルにおけるリンパ球機能に対する柴朴湯の効果315323ENShoichiOkamotoSaiboku-to is a useful drug in the treatment of intractable asthmatics. The most important action mechanism of Saiboku-to seems to be a suppression on lymphocyte activation. The relationship between the in vitro and in vivo effects is not clear because the metabolism of Kampo medicine is unknown. Therefore, in this study two in vitro experimental systems were compared to evaluate the pharmacological effect of Saiboku-to on the lymphocyte blas-togenesis. The first system involved the addition of serum obtained from guinea pigs treated orally with Saiboku-to, while the second system involved the direct additon of the Saiboku-to extract to the medium. Saiboku-to has a suppressive effect on lymphocyte blastogenesis and also the metabolite of Saiboku-to had a suppressive effect. According to the formula based on these data, the serum level of Saiboku-to on oral administration of the common dose was assumed to be 5.65μg/ml in bronchial asthmatics. These findings suggest that Saiboku-to may an inhibitory effect in the cell-mediated allergic reaction by lymohocyte activation in vivo.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581063-41994難治性喘息の治療に関する研究 第1編 モルモット喘息モデルにおける細胞反応型アルルギーに対する柴朴湯の効果305314ENShoichiOkamotoSaiboku-to seems to be a useful drug in the teatment of intractable asthmatics. The pharmacological effect of Saiboku-to was examined in an experimental model of bronchial asthma with cell-mediated allergy in guinea pigs. The fundings revealed that Saiboku-to inhibited the late asthmatic response. It suppressed the lymphocyte blastogensis by ascaris antigen and eosinophil infiltration into BALF and peribronchial tissue. Moreover, Saiboku-to lowered the levls of LTB4 and LTC4 in the cardiac blood, but not the antigen-specific IgG subclass. These findings suggest that the inhibitory effect of Saiboku-to on the late asthmatic response is caused by the suppression of cell-mediated allergy.No potential conflict of interest relevant to this article was reported.