JaLCDOI 10.18926/21182
Title Alternative Prevalence of periCardial effusion in patients with rheumatoid arthritis -An echocardiographic study-
FullText URL pitsr_048_049_054.pdf
Author Ishii, Hirofumi| Domyo, Michihiro| Tanaka, Juntaro| Takasugi, Kiyoshi|
Abstract In order to determine the incidence of pericardial effusion in rheumatoid arthritis (RA), echocardiographic studies were performed on patients with classical or definite RA as determined by ARA criteria, none of whom showed any clinical cardiac symptoms at the time of examination. Of 50 RA patients studied so far, fifteen (30%) showed evidence of posterior pericardial effusion, as recorded on the strip charts. Additionally, in one full-blown case of rheumatoid vasculitis, massive accumulation of pericardial fluid was demonstrable. Compared to those without pericardial effusion, patients shown to have pericardial fluid tended to have decreased RBC, Hct, Hgb, serum protein concentration and increased ESR. The statistical difference between the two groups was significant (P<0.005). The most conspicuous difference between the two, however, was noted in the degree of hypoalbuminemia that is more profound in the effusion positive group (P<0.005). The possible cause of fluid retention in the pericardial cavity in RA was briefly discussed.
Publication Title 岡山大学温泉研究所報告
Published Date 1979-03-25
Volume volume48
Start Page 49
End Page 54
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310937
JaLCDOI 10.18926/21181
Title Alternative A case of SLE with non-erosive joint deformity -Jaccoud's type arthropathy-
FullText URL 048_043_048.pdf
Author Tanaka, Juntaro| Domyo, Michihiro| Takasugi, Kiyoshi| Irino, Shozo| Morinaga, Hiroshi|
Abstract A case of SLE in a twenty-eight year old woman, who had polyarthritis with non-erosive joint deformity, was reported. Differential diagnosis in this case included (1) rheumatoid arthritis (2) postrheumatic fever arthritis (Jaccoud's arthritis) and (3) the overlap syndrome between SLE and rheumatoid arthritis. Laboratory findings on this patient and review on literature, however, strongly suggested that this lady had been suffering from Jaccoud's type arthropathy of SLE. Corticosteroid therapy was initiated and the clinical course of the patient thereafter has been more than favorable.
Publication Title 岡山大学温泉研究所報告
Published Date 1979-03-25
Volume volume48
Start Page 43
End Page 48
ISSN 0369-7142
language 日本語
File Version publisher
NAID 40000321139
JaLCDOI 10.18926/21145
Title Alternative Pulmonary lesions in rheumatoid arthritis-survey of chest radiographs in patients admitted with rheumatoid arthritis during last ten years
FullText URL pitsr_051_001_015.pdf
Author Tanizaki, Yoshiro| Oda, Yasuhiro| Tanaka, Juntaro| Komagoe, Haruki| Takasugi, Kiyoshi| Morinaga, Hiroshi| Harada, Hiroshi| Kimura, Ikuro|
Abstract Chest radiographs were examined in 147 patients with rheumatoid arthritis who were admitted at the Department ofInternal Medicine, Okayama University, Misasa Medical Branch during last ten years. The results were as follows. 1) Diffuse micronodular shadow on chest radiographs was shown in eighty nine out of 147 cases (60.5%), although the incidence of micronodular shadow was 47.3% in the other types except type 1, demonstrating the shadow limitted in the part of lower lung fields. The incidence in type 2 and 3, revealing micronodular shadow distributed over lung fields, was 22.4%. 2) The incidence of micronodular shadow was more frequently found in females than in males. The results obtained here was different from those previously reported. 3) The cases with type 2 and 3 tended to demonstrate a long duration of the desease, acceleration of ESR, positive rheumatoid factors, and elevation of serum γ-globulin and IgG levels, compared with the other types and cases without radiological findings. 4) Pulmonary lesions induced by treatment of gold or penicillamine were not recognized, except one suspected case with gold therapy.
Publication Title 岡山大学温泉研究所報告
Published Date 1981-03-25
Volume volume51
Start Page 1
End Page 15
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310957
JaLCDOI 10.18926/21135
Title Alternative Studies on Rat Peritoneal Mast Cells 2. Effect of BSA on Ca(2+) Uptake of Mast Cells
FullText URL pitsr_052_029_032.pdf
Author Tanizaki, Yoshiro| Tanaka, Juntaro| Komagoe, Haruki| Morinaga, Hiroshi| Kishimoto, Takumi| Kimura, Ikuro| Townley Robert G.|
Abstract To examine the effect of BSA on the cell surface of mast cells, the (45)Ca influx was observed in mast cells from actively sensitized rats and also in cells passively sensitized with IgE-containing serum before or after purification by BSA. The mast cells from actively sensitized rats showed a marked increase in the (45)Ca uptake with stimulation by ovalbumin. The value of (45)Ca uptake by the cells was 1495 ± 104 cpm / 10(5) cells. The uptake of (45)Ca by mast cells passively sensitized before or after separation through BSA was also increased in response to ovalbumin, although the degree of 45Ca uptake by the latter showed marked variation. These results may suggest that BSA affects mast cell surface when the cells are sensitized after separation by BSA.
Publication Title 岡山大学温泉研究所報告
Published Date 1982-03-25
Volume volume52
Start Page 29
End Page 32
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002311041
JaLCDOI 10.18926/21134
Title Alternative Studies on Rat Peritoneal Mast Cells 1. Purification of Mast Cells From Rat Peritoneal Cavity
FullText URL pitsr_052_023_028.pdf
Author Tanizaki, Yoshiro| Tanaka, Juntaro| Komagoe, Haruki| Morinaga, Hiroshi| Kishimoto, Takumi| Kimura, Ikuro| Townley Robert G.|
Abstract To get a high recovery rate of mast cells from the rat peritoneal cavity, a new modified method was discussed using BSA density gradient. Three procedures, peritoneal lavage, washing of peritoneal cells and purification by BSA, were tested in this study, and the numbers of total cells and mast cells in each procedure were calculated. The recovery rate was the highest in BSA density gradient purification of the cells washed once with low speed centrifugation. The recovery rate was 73.7% and the number of mast cells taken from one rat was approximately 1.5×10(6). The purity of the cells with this procedure was 95.0% (range from 93.0 to 96.0%).
Publication Title 岡山大学温泉研究所報告
Published Date 1982-03-25
Volume volume52
Start Page 23
End Page 28
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310940
JaLCDOI 10.18926/21133
Title Alternative Effect of Hot-Air Room Treatment on Peripheral Leucocytes in Guinea Pigs 2. Effect of 30 Min. Hot-Air Room Treatment for 22 Days on Leucocytes Count
FullText URL pitsr_052_013_022.pdf
Author Tanizaki, Yoshiro| Tanaka, Juntaro| Komagoe, Haruki| Oda, Yasuhiro| Nishimura, Yoshiko|
Abstract Numerical changes of peripheral leucocytes after a hot-air room treatment was observed in guinea pigs during the 22 days' successive treatment. The results were as follows. 1. Number of various leucocytes was generally decreased after the hot-air room treatment, followed by recovery to the value before treatments during 22 days' observations. 2. Numbers of total leucocytes, lymphocytes and eosinophils, which were decreased after the treatment, gradually recovered to the value before treatments during the daily hot-air room treatment. On the other hand, the recovery of neutrophils or monocytes to the count before treatment was more rapidly. The value in numerical changes of neutrophils became smaller as the hot-air room treatments were performed for many days. 3. Numerical changes of basophils and Kurloff cells did not show any definite tendency after the hot-air room treatment. 4. Numbers of total leucocytes, neutrophils, lymphocytes and eosinophils were increased and monocyte count was slightly decreased after the 22days hot-air room treatment. No change was observed in the counts of basophils and Kurloff cells.
Publication Title 岡山大学温泉研究所報告
Published Date 1982-03-25
Volume volume52
Start Page 13
End Page 22
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310934
JaLCDOI 10.18926/21124
Title Alternative A case report of a patient with chronic pancreatitis successfully treated by endoscopic elimination of protein plugs
FullText URL pitsr_053_061_065.pdf
Author Takeda, Masahiko| Tanaka, Juntaro| Takasugi, Kiyoshi| Harada, Hideo| Manji, Tadatomi| Morinaga, Hiroshi| Tsurumi, Tetsuya| Fujii, Yasuhisa|
Abstract Presented here is a case report of a 56 years old male patient with chronic pancreatitis in which a dramatic improvement in symptoms and objective findings were noted after endoscopic elimination of protein plugs. In September, 1979, he had an acute onset of pancreatitis followed by pseudocyst formation and the following combined operations were performed: resection of the pseudocyst, resection of the body and tail of the pancreas along with the spleen, partial resection of the stomach and the transverse colon, and gastroenterostomy according to Billroth I method. He had been followed up at out-patient clinic for chronic pancreatitis and diabetes until January 14,1979 when he was hospitalized for anorexia, loss of weight, pretibial edema, and upper-abdominal pain. The patient's condition was characterized by emaciation (height 152 cm, weight 37 kg), anemia (Hb 7.9g/dl), hypoproteinemia (serum protein 4.2 g/dl) , and hypolipidemia (total cholesterol 73 mg/dl). Abdominal ultrasound, abdominal CT and ERCP revealed stones in the pancreatic duct. Symptoms and objective findings were only partially improved by medical regimens. Subsequently we performed endoscopic cannulation of the pancreatic duct for elimination of pancreatic stones. Successful elimination of large numbers of protein plugs resulted in dramatic improvement of symptoms and objective findings. This procedure proved to add a new important tool in the treatment of chronic pancreatitis.
Publication Title 岡山大学温泉研究所報告
Published Date 1983-03-25
Volume volume53
Start Page 61
End Page 65
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002311007
JaLCDOI 10.18926/21123
Title Alternative Role of endoscopic elimination of protein plug in the treatment of chronic pancreatitis
FullText URL 053_057_060.pdf
Author Tanaka, Juntaro| Takeda, Masahiko| Takasugi, Kiyoshi| Harada, Hideo| Manji, Tadatomi|
Abstract Endoscopic aspiration of pure pancreatic juice (ppj) was performed on 65 patients with chronic pancreatitis (cp) or suspected CP primarily for evaluating the validity of biochemical and physiochemical analysis of PPJ in the study of pathogenesis, pathophysiology and diagnosis of CP. PPJ was collected from within the main pancreatic duct by endoscopic retrograde catheterization of the papilla. With increasing experience, it has been revealed that various numbers of protein plugs are contained in PPJ obteined from patients with CP or suspected CP and that endoscopic elimination of protein plugs can provide them with dramatic relief from abdominal pain and back pain. The purpose of this report is to evaluate the role of endoscopic elimination of protein plugs in the treatment of CP. The following conclusions were obteined: (1) endoscopic elimination of protein plugs from within the pancreatic duct is useful. at least on a short-term basis, for relieving abdominal pain and back pain in one-forth of patients with CP or suspected CP; (2) this procedure can be an effective therapeutic tool in selected cases of CP or suspected CP where no prominent stenotic lesions are noted in the major pancreatic duct system and abstinence from alcohol bevarage is strictly observed.
Publication Title 岡山大学温泉研究所報告
Published Date 1983-03-25
Volume volume53
Start Page 57
End Page 60
ISSN 0369-7142
language 日本語
File Version publisher
NAID 40000321176
JaLCDOI 10.18926/21107
Title Alternative An evaluation of pancreatographic findings in the differential diagnosis of chronic pancreatitis and pancreatic cancer
FullText URL pitsr_054_039_041.pdf
Author Tanaka, Juntaro| Ochi, Koji| Irie, Seiji| Takeda, Masahiko| Harada, Hideo|
Abstract In an attempt to evaluate the pancreatographic findings, particularly of the pancreatic duct branches, in the differrential diagnosis of chronic pancreatitis and Pancreatic cancer, twenty seven post mortem pancreases were subjected to retrograde pancreatography and histological examination. The materials consist of 15 cases with chronic pancreatitis and 12 cases with pancreatic cancer. The results obtained are as follows. 1) In cases with chronic pancreatitis, abnormal findindings such as irregular dilatation, straightening-hardening, narrowing-stenosis of the pancreatic duct branches were more common. 2) Incases with pancreatic cancer, abnormal findings such as diminishing, irregular dilatation, narrowing-stenosis of the pancreatic duct branches were more common. 3) Abnormal findings in cases with chronic pancreatitis reveled the dendency of diffuse expansion, on the other hand, in case with pancreatic cancer revealed the tendency of localized expansion. 4) When the fine and clear pancreatography was obtained, it was possible to predict the presence of chronic inflammation or tumor cell infiltration from above findings and tendencies. On the contrary, in cases with localized, severe chronic pancreatitis and in cases with complicated, it was difficult to differentiate the pancreatic cancer from chronic pancreatitis.
Publication Title 岡山大学温泉研究所報告
Published Date 1984-03-25
Volume volume54
Start Page 39
End Page 41
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310981
JaLCDOI 10.18926/21087
Title Alternative Endoscopic diagosis of gastric malignant lymphoma
FullText URL pitsr_056_045_052.pdf
Author Miyake, Hirofumi| Harada, Hideo| Yasuoka, Masatoshi| Oka, Hiroo| Matsumoto, Shuji| Ochi, Koji| Takeda, Masahiko| Tanaka, Juntaro| Ohnoshi, Taisuke| Kimura, Ikuro|
Abstract To delineate the pitfalls and counter-measures in the endoscopic diagnosis of gastric malignant lymphoma (GML), reviewed were 32 cases of primary GML and 16 cases of systemic ML with gastric involvement (secondary GML). 1) Accurate diagnosis of GML had been made in only 13 cases of primary GML ; 18 cases had been diagnosed of gastric cancer (GC); the remaining one of benign ulcer (BU). Review of the endoscopic films, however, revealed more than two of the three findings characteristic, but not pathognomomic, of GML in 84 percent. This result indicates that possibility of GML must be kept in mind in the differential diagnosis of malignant lesions despite its rarity, because endoscopists tend to be predisposed with an impression of GC. 2) Follow-up examinations made in nine cases of primary GML revealed marked changes in endoscopic findings in three cases : healing of an ulcer lesion in one case, healing of an ulcer lesion on an unchanged tumor in another and enlargement of a tumor in the remaining one. The first case had been followed up for two years with an impression of BU. This result indicates that improvement of ulcer does not necessarily rule out GML because it can show "malignant cycle" just as GC. 3) Endoscopic biopsy performed in 30 cases of primary GML had led to accurate diagnosis in only 16 cases and erroneous diagnosis of GC in five and no malignancy in nine. Review of the cases revealed the importance of having suspicion of GML at first from endoscopic findings, because it can lead to an increase of the number of biopsy specimens, careful selection of biopsy sites, careful use of biopsy instruments to obtain good specimens and closer contact with pathologists. 4) Prospective studies on systemic ML revealed gastric involvement in 17 percent. Examinations of the GI tract, especially of the stomach is one of the important steps for staging of systemic ML and deciding therapeutic modalities. 5) It is extremely difficult to diffierentate primary GML and secondary GML from endoscopic findings alone, although there are a few findings characteristic of the latter.
Publication Title 岡山大学温泉研究所報告
Published Date 1985-03-30
Volume volume56
Start Page 45
End Page 52
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310992
JaLCDOI 10.18926/19825
Title Alternative Classification and concepts of pancreatitis
FullText URL 060_083_093.pdf
Author Harada, Hideo| Tanaka, Juntaro| Ochi, Koji| Matsumoto, Shuji| Ishibashi, Tadaaki| Seno, Toshinobu| Miyake, Hirofumi|
Abstract 膵炎の分類は膵臓研究の進歩とともに変遷を重ねたが,ここ20年間はマルセイユ分類(1963年)が国際的に広く用いられてきた。しかし最近,膵検査法の進歩と膵研究の知見の蓄積を背景にして,ケンブリッジ(1983年),マルセイユ(1984年),およびローマ(1988年)において分類の改訂を目的に国際シンポジウムが開催され,それぞれに新しい膵炎の分類が提案された。各分類には多くの共通点が見られるが重要な相違点もある。各分類を十分に理解していないとしばらくは混乱に陥ることが危惧される。幸い筆者の1人はこれらのシンポジウムに招待され参加する機会を得たので,成文の背景にある討議を詳しく紹介し,各分類を比較しながらその特徴を述べた。それとともに将来理想的な分類を完成するために今後検討すべき課題をも指摘した。そして,これら分類の当面の利用法に関する筆者らの提案を述べた。
Abstract Alternative The present paper is a review of the historical changes in the classification and concept of pancreatitis. The Marseille classification and concept had enjoyed its international popularity for more than 20 years since it was adopted at the first Marseille symposium in 1962. However, the recent advancement in the study of the pancreas led to the attempts to revise the classification and concept of pancreatitis : International Symposium in Cambridge in 1983, Second International Symposium in Marseille in 1984 and Symposium at the International Congress of Gastroenterology in Rome in 1988. As one of us was invited to the last two symposia, we described the details of the revised classification and concept of Marseille (1984) and of Marseille-Rome (1988) ; then, we described the similarities and differences between the Cambridge classification, the revised Marseille classification and the Marseille-Rome classification. Finally we summarized the subjects to be further investigated to make better classification of pancreatitis in the future.
Keywords 膵炎 分類 (Classification and concepts of pancreatitis) 急性膵炎 (Acute pancreatitis) 慢性膵炎 (Chronic pancreatitis)
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 83
End Page 93
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309066
JaLCDOI 10.18926/19821
Title Alternative Interstitial matrix components in relation to the pathogenesis of fibrosis
FullText URL 060_076_082.pdf
Author Seno, Toshinobu| Harada, Hideo| Ochi, Koji| Tanaka, Juntaro| Matsumoto, Shuji| Ishibashi, Tadaaki| Takeda, Masahiko| Miyake, Hirofumi|
Abstract 慢性膵炎の症例は近年増加の一途をたどっており,その発症機序と病態の解明および対策の確立が急がれている。慢性膵炎の重要な所見の一つである膵間質線維化の発生機序の解明および早期発見法の確立は重要な課題であるが,従来の知見は断片的にすぎない。そこで,筆者らは膵線維化の系統的な研究を始めるにあたって,細胞間マトリックスの構成成分と線維化に関する従来の知見および今後の課題を整理した。細胞間マトリックスのうちでも特にコラーゲン,グリコサミノグリカン,フィブロネクチンをとりあげ,その構造と機能および組織の線維化形成における役割について文献的考察を行った。今後,膵組織および膵液中のプロリンハイドロキシラーゼ,コラーゲンとその型別分布および各型コラーゲンの比,ヘキソサミン,デルマタン硫酸,フィブロネクチン,ラミニンを検討することが重要と思われた。
Abstract Alternative Increasing numbers of patients with chronic pancreatitis have been reported all over the world, including Japan. Pathogenesis of chronic pancreatitis has remained to be revealed and the early detection has remaind difficult despite extensive investigations. Interstitial fibrosis forms one of the most important histopathological features of chronic pancreatitis along with loss of parenchyma and irregular dilatation of the ducts and ductules. However, only a limited numbers of reports have been pubiished on the pathogenetic mechanisms of interstitial fibrosis of the pancres, because tissue materials are not easily accessible and blood samples can hardly reflect the fibrotic process of the pancreas unlike the case of the iiver. Our Preliminary studies revealed that biochemical and immunochemical analysis of pure pancreatic juice, such as determination of collagen, hexosamine, fibronectin and proline hydroxylase, might reflect the fibrotic process of the pancreas. The results led us to review the earlier reports on inter-cellular matrix in relation to the formation of fibrosis to find suitable markers to be evaluated in the future systematic investigations. The review revealed that pure pancreatic juice should be analyzed for collagen, types of collagen, hexosamine, dermatan sulfate, fibronectin, larninin, proline hydroxylase, collagenase and cathepsin B(1).
Keywords 慢性膵炎 (Chronic pancreatitis) 膵の線維化 (Interstitial fibrosis of the pancreas) 膵間質成分 (Interstitial matrix of the pancreas)
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 76
End Page 82
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309179
JaLCDOI 10.18926/19797
Title Alternative Clinical evaluation of co-examination by sigmoidoscopy and barium enema study for early diagnosis of colon cancer
FullText URL 060_039_046.pdf
Author Ochi, Koji| Ishibashi, Tadaaki| Matsumoto, Shuji| Seno, Toshinobu| Tanaka, Juntaro| Harada, Hideo| Akiyama, Tsuneo| Nakai, Mutsurou| Hayashimoto, Kanae|
Abstract 注腸・内視鏡同日併用法の大腸早期癌診断における有用性の検討,その診断能向上のための検査前日食改善を目的に,同法を施行した94例の診断能,従来のBrown変法に準じた献立食とレトルト食(サンケンクリン)とのX線画像の質,内視鏡時の残渣の程度,被検者への味のアンケートを分析した。発見大腸腫瘍は癌5例(早期癌2例,進行癌3例),ポリープ26例32病変である。早期癌はともにポリープの形態をとり,注腸,内視鏡とも病変を指摘できた。病変の好発部位である直腸・S状結腸で注腸・内視鏡によるダブルチェックができる。前日食の検討ではレトルト食が従来の献立食と比し,注腸・内視鏡ともに優れた腸内洗浄能を有し,味のアンケートからも劣ることはなかった。大腸癌早期発見の2次スクリーニングとして,レトルト食を前日食とする同法の有用性が示された。
Abstract Alternative The present study was performed (1) to evaluate the validity of co-examination by sigmoidoscopy and barium enema study for the early diagnosis of colon cancer and (2) to find the most suitable preparation method for the co-examination. The co-examination was performed on 94 patients : those with abdominal symptoms and signs suggestive of colonic diseases : those with positive occult blood test in stool : or those asking for the routine examination of the colon. The examination revealed 5 cases of colon cancer (2 with early cancer and 3 with advanced cancer) and 26 eases (32 lesions) with colon polyp. The high detection rate of colonic neoplasms, especially of minute lesions, along with the high rate of early lesions among cancers suggested the validity of the co-examination method for the early diagnosis of colon cancer. The method was not time-consuming and not demanding for both patients and doctors, but was effective in detecting minute lesions by allowing a doublecheck in the high-risk recto-sigmpid region ; in addition, the upper colon could be examined by X-ray. The comparative studies on the currently popular Preparation method (modified Brown's method) and a new method with retort foods (Sankenclean, Sanwa Kagaku Kenkyusho Co., Ltd) revealed that the latter was significantly more effective in cleaning colon lumen and visualizing fine network pattern of the colonic mucosa. In addition, the patients were more satisfied with the taste of the latter.
Keywords 大腸早期癌 (Ealry diagnosis of colon cancer) 注腸・内視鏡同日併用法 (Co-examination by sigmoidoscopy and barium enema study) 大腸検査前処置 (Preparation for colon examination)
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 39
End Page 46
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309136
JaLCDOI 10.18926/19775
Title Alternative Effect of long-term daily intake of thermal water on gastric mucosal blood flow
FullText URL 060_001_005.pdf
Author Tanaka, Juntaro| Senou, Toshinobu| Matumoto, Shuji| Ishibashi, Tadaaki| Ochi, Koji| Harada, Hideo|
Abstract 内視鏡(オリンパス製XQ-10胃ファイバースコープ)と臓器反射スペクトル法を応用して,2週間連日の飲泉が胃粘膜血流におよぼす効果を検討した。健常者3名および胃疾患患者9名(治癒期にある胃潰瘍の患者6名と慢性胃炎の患者3名)を対象とした。当院飲泉場の温泉水による2週間連日の飲泉を行ない,2週間の飲泉の前後において,胃の3箇所(胃幽門部小弯,前庭部小弯,胃角部小弯)で胃粘膜血流を測定した。その結果,胃前庭部小弯では胃粘膜血流の有意の増加を認めた。しかし胃全体としては有意差を検出出来なかった。個々の症例について検討すると、飲泉後で胃の3箇所すべてにおいて血流が増加したケースが頻度多く認められ,飲泉の有効性が示唆された。従来から認められてきた慢性胃腸疾患に対する飲泉の効果には,胃粘膜血流の改善による要因も加わっている可能性が考えられる。
Abstract Alternative Effect of long-term oral intake of thermal water on gastric mucosal blood flow was evaluated, using an endoscopic organ reflex spectrophotometry together along with an Olympus XQ-10 forward viewing gastro-fiberscope. Three healthy volunteers and nine patients with gastric diseases in remission (six with healed gastric ulcer and three with chronic gastritis) were put on a 2-week treatment with daily oral intake of Misasa thermal water (38 to 42 ℃, 200mℓ, two times a day between meals). Gastric mucosal blood flow was measured just before and after the treatment period at three spots of the stomach (lesser curvature of the pylorus, antrum and angle) : Life style and drugs were unchanged during the period. Following results were obtained : (1) Pre-and post-treatment gastric mucosal blood flow (IHb) was 95.0±18.0, and 98.2±15.3 at the pylorus, respectively ; 104.8±16.9 and 110.8±12.8 at the antrum, respectively ; 116.1±20.4 and 118.7±18.5 at the angle, respectively. (2) However, Evaluation of each individual case showed that the post-treatment values were higher than the pretreatment ones in 75 % of patients at the pylorus and in 67 % of patients at the antrum and angle, respectively. (3) Student's paired t-test showed that the post-treatment increase in blood flow was statistically significant (p<0.05) only at the antrum. These results suggest that an improvement in gastric mucosal blood flow, along with an improvement in gastric secretion and motility, is also contributory to the favorable therapeutic results of spa-drink in chronic gastric diseases. Further studies are in progress to reveal (1) the clinical significance of the improvement in gastric mucosial blood flow, such asacceleration of healing and maintenance of remission, and (2) the characteristics of patients who are likely to show favorable response to the treatment.
Keywords 飲泉療法 (Spa-drink therapy) 胃粘膜血流 (Gastric mucosal blood flow) 臓器反射スペクトル法 (Organ reflex spectrophotometry)
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 1
End Page 5
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309006
JaLCDOI 10.18926/19771
Title Alternative トランスフェリンを介する鉄の細胞内取り込み機序 ―特に肝細胞への取り込みにおける内皮細胞の関与について―
FullText URL 059_083_092.pdf
Author Irie, Seiji| Matsumoto, Shuji| Ochi, Koji| Takeda, Masahiko| Tanaka, Juntaro| Harada, Hideo| Mehdi, Tavassoli|
Abstract Transferrin (Tf) is thought to play a pivotal role in iron metabolism of various kinds of cells. Tf has specific receptors on the surface of the cells that require iron. Tf-receptor binding is followed by internalization through a system of coated pits and vesicles. The rapid decline of pH of these vesicles leads to the release and sequestration of iron by the cell. Apotransferrin-receptor complex returns to the cell surface, where under neutral pH conditions, apotransferrin is dissociated from the receptor. Recent advances in cellular and molecular biology, gene cloning and monoclonal antibody technique have elucidated many features of these processes at a molecular level. These advances are briefly reviewed, and particularly, our own observations concerning endothelial mediation of uptake of Tf by hepatocytes are discussed.
Abstract Alternative トランスフェリン(Tf)は鉄代謝において重要な役割を担っている。鉄を必要とする細胞の表面には,Tfの特異的受容体が存在し,Ffは受容体との結合に引き続いて,coated pitsとcoated vesiclesを介して細胞内に取り込まれる(internalization)。Vesicle内での急速なpHの低下にともない,鉄はTfから分離し,細胞内で分画される。一方,鉄を失ったTf(アポTf)は受容体と結合したまま細胞表面にもどり,中性のpHのもとで受容体から解離する。最近の細胞・分子生物学の進歩,遺伝子クローニング,ならびにモノクローナル抗体の開発により,分子レベルで鉄代謝経路が解明されつつある。今回,これまでの主要な知見をまとめ,特に,最近筆者らの研究により明らかとなった,肝の鉄代謝における内皮細胞の役割について考察した。
Keywords Iron uptake (鉄の細胞内取り込み) Transferrin (トランスフェリン) Receptor-Mediated Endocytosis Desialation (脱シアル化) Endothelium (内皮細胞)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 83
End Page 92
ISSN 0913-3771
language 英語
File Version publisher
NAID 120002309113
JaLCDOI 10.18926/19770
Title Alternative Etiology and pathogenesis of chronic pancreatitis
FullText URL 059_068_082.pdf
Author Harada, Hideo| Matsumoto, Shuji| Ochi, Koji| Takeda, Masahiko| Senou, Toshinobu| Irie, Seiji| Tanaka, Juntaro|
Abstract 慢性膵炎の成因の主たるものは,アルコール性,特発性,胆石性である。病態面では,社会的・家庭的にもっとも責任が重い壮年期に頑固な疼痛,消化吸収障害,二次性糖尿病のために生活の質が低下することが問題になる。経過中に併発してくる膵およびそのほかの臓器の癌,および糖尿病の合併症による死亡も少なくない。アルコール性慢性膵炎の初期病変の発生機序としては,①膵過分泌の結果として細膵管内に形成される蛋白栓による膵液流出障害と,②蛋白栓あるいはアルコールの直接障害作用による細膵管上皮の損傷,およびその結果生じる膵管狭窄による膵液流出障害が注目されている。膵液流出障害はその上流域に実質細胞の破壊と間質の線維化をおこす。膵液には多くの生化学的異常が認められ,いったん発生した膵管の構造異常とあいまって慢性膵炎進展の原因となる。素因および栄養のアンバランスは発症,進展の促進因子となる。発症を予防し,進展を阻止する手段を開発するためには素因および飲酒・食事を含む環境因子の解析が今後の重要な課題である。
Abstract Alternative Main etiologies of chronic pancreatitis (CP)include "alcoholic" (60%), "idiopathic" (27%)and "biliary" (8%). Clinico-pathological features comprise intractable abdominal pain, maldigestion secodary to exocrine pancreatic insufficiency and diabetes secondary to endocrine pancreatic insufficiency. Death is not infrequent during follow-up. Pathogenesis and evolution of alcoholic CP were discussed in connection with "Big Duct Theory", "Toxic-Metabolic Theory", and "Protein Plug Theory". Diet and congenital predisposition as well as alcoholic comsumption play important roles in various combinations in the pathogenesis and evolution of CP. Important initial lesins of alcoholic CP are probably : (1) pancreatic ductular Obstruction due to proetin plug formation resulting from increased protein and mucoprotein concentration in pancreatic juice ; (2) damage and sloughing of ductular epithelia caused by protein plugs or by a direct toxic effect of ethanol secreted into pancreatic juice, and subsequent ductular stenosis and peri-ductular fibrosis. Parenchymal destruction with interstitial fibrosis is induced upstream to the ductular lesions. These, structural abnormalities and multiple biochemical abnormalities of pancreatic juice further lead to self-perpetuating evolution. Anti-acinar-cell antibody, anti-duet-cell antibody and immune complex in serum are most probably mere epiphenomena and not the causes of CP.
Keywords 慢性膵炎 (Chronic pancreatitis) 成因 (Etiology) 発生機序 (Pathogenesis)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 68
End Page 82
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002308982
JaLCDOI 10.18926/19752
Title Alternative Early diagnosis of pancreatic cancertrial of a mass screening test for detecting early pancreatic cancer
FullText URL 059_024_030.pdf
Author Matsumoto, Shuji| Ochi, Koji| Irie, Seiji| Takeda, Masahiko| Tanaka, Juntaro| Harada, Hideo|
Abstract 膵癌を治癒に導くためには早期診断,早期切除以外に方法はない。そこで,無症状者のなかから早期膵癌を発見するためのスクリーニング法を検討するためProspective studyを実施した。人間ドック目的の来院患者を主とする三朝分院外来患者776名を対象とし,一次スクリーニング検査として,血清アミラーゼ,エラスターゼⅠ,CA19-9,アルカリフォスファターゼ,γ-GTP,血糖値の測定および腹部超音波検査を施行し,異常者に対して二次スクリーニングとして腹部超音波検査の再精査およびERCPを施行した。その結果,早期膵癌1例および進行膵癌2例を検出し,膵癌発見率は0.39% と満足のいく結果が得られた。しかし一次スクリーニング検査の要精検率は46% と高値を示したこと,一次スクリーニング検査の費用は胃集検の約3.3倍,二次スクリーニング検査の費用は胃精査の約2.6倍かかることからcost-benifitの面で問題となった。また見逃し症例の有無をモニターするためfollow upも今後の問題として残った。
Abstract Alternative There is no other way of curing pancreatic cancer than early diagnosis and resection. However, an effective protocol has not been established for detecting early pancreatic cancer among asymptomatic populations by means of a mass screening test. Therefore, a prospective study was attempted on 776 patients who came to Medical Clinic of Misasa Branch Hospital, Okayama University Medical School mostly for a routine annual check-up. The following tentative protocol was proposed, based on the retrospective analyses of our 13 patients with early pancreatic cancer: (1) a first step test includes serum amylase, elastase Ⅰ, alkaline phosphatase, r-GTP, carcinoembryonic antigen, fasting blood sugar and routine abdominal ultrasonography (US); (2) a second step test includes thorough abdominal US with various kinds of probes and patients' positioning which was performed on individuals with abnormal findings on the first step test, (3) a third step test includes ERCP which was performed on individuals with abnormal or questionable findings on the second step test. Further detail examinations were performed when ERCP was abnormal or questionable. Consequently 357 patients (46% of the total 776 patients) underwent thorough US and 45 patients (5.8%) underwent ERCP. ERCP findings included pancreatic cancer in two patients, suspect of pancreatic cancer in three, advanced chronic pancreatitis in two, equivocal as for chronic pancreatitis (according to the Cambridge classification) in nine, and normal in 29. Final diagnosis was early pancreatic cancer in one patient, advanced pancreatic cancer in two, and calcified chronic pancreatitis in two; detection rate of pancreatic cancer (0.39%) in this series was slightly higher than that usually reported with a mass screening test for stomach cancer. From a cost-benefit point of view, however, examinations for the pancreas cost 2.6 times as much as those for the stomach. Further studies are needed (1) to refine the protocol, (2) to improve cost-benefit efficiency, (3) and also to confirm by follow-up that no cases of pancreatic cancer have passed through the test undetected.
Keywords 膵集検 (Mass screening) 早期膵癌 (Early pancreatic cancer) 膵癌の早期診断 (Early diagnosis of pancreatic cancer)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 24
End Page 30
ISSN 09133771
language 日本語
File Version publisher
NAID 120002309153
JaLCDOI 10.18926/19750
Title Alternative Clinical evaluation of endoscopic ultrasonography (EUS) in the diagnosis of gastric disease.
FullText URL 059_017_023.pdf
Author Ochi, Koji| Harada, Hideo| Matsumoto, Shuji| Irie, Seiji| Takeda, Masahiko| Tanaka, Juntaro|
Abstract ラジアルセクタ式超音波内視鏡(EUS)を,15例の胃疾患患者に用い,その有用性を検討した。胃癌の深達度診断は併存潰瘍を有するm癌の1例をsm癌とした以外は,いずれも正診であり,胃癌の深達度診断にEUSが有用であることが示唆された。その他,胃粘膜下腫瘍の占拠部位や発育様式の診断や壁外性圧排との鑑別など胃疾患の診断にEUSの有用性が示唆され,文献的考察を加えて報告した。
Abstract Alternative We performed EUS in seven cases with gastric cancer, one with gastric malignant lymphoma, two with submucosal tumor of the stomach (SMT), two with tumourous compression by extra-gastric organs and three with others. Except one case with early gastric cancer, the depth of cancerous lnvasion was correct1y diagnosed by EUS. It was posible to detect which layer had SMT in the 5 layer strcture of the gastric wall by EUS and it was helpful in determination of histological origin of SMT. Furthermore EUS was able to make the differential diagnosis between SMT and tumourous compression by extra gastric organ. Our result showed that EUS was a useful procedure in the diagnosis of gastric diseases.
Keywords 超音波内視鏡 (Endoscopic ultrasonography) 胃癌 (Gastric cancer) 胃粘膜下腫瘍 (Submucosal tumor of the stomach) 癌深達度診断 (Diagnosis of the depth of cancerous invasion)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 17
End Page 23
ISSN 09133771
language 日本語
File Version publisher
NAID 120002309109
JaLCDOI 10.18926/19747
Title Alternative Characteristic pancreatographic findings in chronic pancreatitis and their diagnostic value. …Studies on post mortem pancreas…
FullText URL 059_012_016.pdf
Author Tanaka, Juntaro| Matumoto, Shuuji| Ochi, Kouji| Irie, Seiji| Takeda, Masahiko| Harada, Hideo|
Abstract 慢性膵炎25例および対照として正常例125例計150例の新鮮剖検膵を用いて膵管造影を行い,X線所見と同部位の組織所見とを厳密に対比させ,慢性膵炎における各X線所見の診断学的価値を検討した。その結果,主膵管像では不整拡張像,硬化+辺縁不整像,狭窄+辺縁不整像が,分枝像では不整拡張像および不整配列像が,positive predictive value(PPV),specificity(Sf),negative predictive value(NVP)ともに77.1~100% の高率を示した。しかしsensitivity(St)は,2.1~18.1% と低率であった。したがって,これらの所見は慢性膵炎を診断する上で組織予見性および特異性に優れた診断的価値のあるX線所見と言える。しかし一方では軽症の慢性膵炎の検出能はあまりよくないという限界が膵管造影法にはある。
Abstract Alternative Postmortem pancreas tissue was prepared within 6 hours of death for the comparative study of pancreatographic findings and histological findings to define characteristic pancreatographic findings of chronic pancreatitis and determine their diagnostic value. Pancreas tissue was obtained from 25 patients with chronic pancreatitis and 125 with a normal pancreas. Among various pancreatographic findings, irregular dilatation and irregular arrangement of the branches of the pancreatic duct, and also irregular dilatation, rigidity with irregular margin and stenosis with irregular margin of the main pancreatic duct showed the highest sensitivity. specificity, positive predictive value and negative predictive value and conseqently had the highest diagnostic valus. However, the sensitivity was not high enough, indicating that the above pancreatographic findings could be absent at the site of positive histological findings in mild chronic pancreatitis.
Keywords 慢性膵炎 (chronic pancreatitis) 膵管造影像 (pancreatogpaphy)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 12
End Page 16
ISSN 09133771
language 日本語
File Version publisher
NAID 120002309156
JaLCDOI 10.18926/19715
Title Alternative Effect of spa-drink therapy on exocrine pancreatic function
FullText URL 058_012_016.pdf
Author Matsumoto, Shuji| Harada, Hideo| Ochi, Koji| Takeda, Masahiko| Tanaka, Juntaro| Senou, Toshinobu| Irie, Seiji| Ishibashi, Tadaaki| Kimura, Ikuro|
Abstract 膵外分泌機能におよぼす飲泉(三朝温泉水)の効果を飲泉群および非飲泉群を対象として検討した。膵外分泌機能検査法としては,糞便中キモトリプシン活性比色測定法(モノテストカイモトリプシン)を用いた。その結果,糞便中キモトリプシン活性は,飲泉開始2週後に40 % の患者で上昇し,4週後は2週後と変わらなかった。以上より,2週間の飲泉は膵外分泌機能を改善させる効果があることがわかった。
Abstract Alternative The effect of spa-drink therapy (Misasa hot spring) on exocrine pancreatic function was studied on 18 patients after their physical and psychological conditions were stabilized about two weeks following hospitalization. Patients were randomly divided into two groups : eight patients into a control group (continuance of spa-bathing) and 10 patients into a spa-drink therapy group (continuance of spa-bathing plus commencement of spa-drink therapy). Spa-drink therapy refers to drinking 200mℓ of warm spa-water (42℃) two times a day : between meals in the morning and in the afternoon. Exocrine pancreatic function was evaluated by fecal chymotrypsin activity, using a colorimetric method (Boehringer-Mannheim). Following results were obtained : 1) With 2-week's spa-drink therapy, fecal chymotrypsin activity was significantly enhanced in 40 % of the patients, while none of the controls showed an increase in fecal chymotrypsin activity. 2) Fecal chymotrypsin activity at the time of 4 weeks was similar to that obtained at the time of 2 weeks in both groups. In conclusion, spa-drink therapy for 2 weeks was effective for the enhancement of exocrine pancreatic function.
Keywords 糞便中キモトリプシン活性 (Fecal chymotrypsin activity) 飲泉療法 (Spa-drink therapy) 膵外分泌機能 (Pancreatic exocrine function) 膵 (Pancreas) 酵素 (Enzyme)
Publication Title 環境病態研報告
Published Date 1987-08
Volume volume58
Start Page 12
End Page 16
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309038