JaLCDOI 10.18926/19771
タイトル(別表記) 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―
フルテキストURL 059_083_092.pdf
著者 入江 誠治| 松本 秀次| 越智 浩二| 武田 正彦| 田中 淳太郎| 原田 英雄| Mehdi, Tavassoli|
抄録 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.
抄録(別表記) 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。
キーワード 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)
出版物タイトル 環境病態研報告
発行日 1988-08
59巻
開始ページ 83
終了ページ 92
ISSN 0913-3771
言語 English
論文のバージョン publisher
NAID 120002309113
JaLCDOI 10.18926/15151
フルテキストURL 065_027_039.pdf
著者 Chowdhury, Riaz| 越智 浩二| 田中 淳太郎| 松本 秀次| 妹尾 敏伸| 原田 英雄| 水島 孝明| 谷崎 勝朗|
抄録 Tropical calcific pancreatitis is a nonalcoholic type of chronic pancreatitis affecting the childrens and young adults characterized clinically by recurrent abdominal pain in childhood, diabetes in adolescent and death in early childhood. Although the exact etiology is not known, malnutrition and chronic cassava toxicity either singly or in combination are presumed to be the prime factor in pancreatic injury unopposed by detoxification of free radical. Moreover micronutrients deficiency, oxidant stress and antioxidant deficiency might play substantial role. Diabetes secondary to tropical calcific pancreatitis is a distinctive and frequent problem, being named by W.H.O. study group as 'fibrocalculous pancreatic diabetes (FCPD) and classified as one of the variant of the so-called malnutrition related diabetes mellitus (MRDM).
抄録(別表記) 熱帯地方の貧困層の小児や若干成人にみられる非アルコール性の慢性膵炎で,小児期に反復する腹痛で発症し,10~20歳で膵性糖尿病になり,20~ 30歳で死亡する類似の病像を示す症例をTropical calcific pancreatitis(熱帯性石灰化慢性膵炎)という。高率に膵石を伴う。成因は乳幼児期からの熱量,蛋白貰,micronutrients(亜鉛,銅,セレニウム)の摂取不足に加えて食事中シアン産生物質や環境中oxidantsなど複合因子によると推測されている。病理像は世界各国にみられる慢性膵炎典型例に類似する。最近は,生活環境や医療事情の改善により,全身栄養障害の減少や生存期間 の延長など病像が変貌しっつある。糖尿病を重視する立場からはFibrocalculous pancreatic diabetesと呼ばれ,同一地域にみられるProtein-deficient pancreatic diabetesと合わせてMalnutrition-related diabetes mellitus(MRDM)と総称し,糖尿病の一亜型に分類されている。
キーワード Tropical calcific pancreatitis (TCP) malnutrition cassava diabetes abdominal pain
出版物タイトル 岡大三朝分院研究報告
発行日 1994-09
65巻
開始ページ 27
終了ページ 39
ISSN 0918-7839
言語 English
論文のバージョン publisher
NAID 120002307678
JaLCDOI 10.18926/15091
タイトル(別表記) Ⅱ型喘息(細気管支閉塞型)と気管支肺胞洗浄液の好中球数
フルテキストURL 067_079_084.pdf
著者 谷崎 勝朗| 御舩 尚志| 光延 文裕| 保崎 泰弘| 芦田 耕三| 横田 聡| 柘野 浩史| 竹内 一昭| 名和 由一郎| 越智 浩二| 原田 英雄| 池田 敏| 武田 和久|
抄録 Bronchial asthma is classified into three types ; type Ia (Ia-1 and Ia-2), type Ib, and type Ⅱ, by clinical symptoms (clinical diagnosis). Asthma is also classified by clinical findings and examinations (score diagnosis). Both classification systems show that markedly increased proportion of BAL neutrophils and marked decrease in % V25 value are characteristic of type Ⅱ, bronchiolar obstruction, asthma. However, there are some type Ⅱ asthma patients without BAL neutrophilia. In these patients, age is higher compared to those with BAL enutrophlia. Decrease in FEV1.0% value and decrease in the proportion of BAL lympocytes and serum IgG level, are not so remarkable as decrease in those with BAL neutrophilia. It has been suggested that type Ⅱ asthma with BAL neutrophilia correlates with suppression of humoral and cellular immunity, and same type of astma without BAL neutrophilia is in part caused by aging.
抄録(別表記) 気管支喘息は,その臨床症状より,Ia型(Ia-1およびIa-2),Ib型およびⅡ型の3つの病型に分けることができる(臨床分類)。また,同時に臨床所見および検査により分類することができる(スコアー分類)。いずれの分類においても,BAL液中の好中球の著増および高度な% V25値の低下がⅡ細気管支閉塞型の特徴的所見である。しかしながら,BAL液中の好中球の増加をともなわないⅡ型喘息が存在することが明らかにされている。これらの症例では,BAL液 中好中球増加をともなう症例に比べ平均年齢が高い。しかし,FEVl.0% 値、BAL液中リンパ球頻度や血清IgG値などは、好中球増加をともなう症例ほどの低下傾向は見られない。これらの結果はBAL液中好中球増加をともなうⅡ型z喘息の発症機序には、液性および細胞性免疫能の低下が、また、BAL液中好中球増加をともなわないⅡ型喘息では、加齢がある程度関連していることを示 している。
キーワード Asthma classification (喘息分類) BAL lymphocytes (BALリンパ球) BAL neutrophils (BAL好中球) % V25 value Ⅱ型喘息
出版物タイトル 岡大三朝分院研究報告
発行日 1996-11
67巻
開始ページ 79
終了ページ 84
ISSN 0918-7839
言語 English
論文のバージョン publisher
NAID 120002307924
JaLCDOI 10.18926/15041
タイトル(別表記) Alcohol-induced pancreatitis
フルテキストURL 062_052_070.pdf
著者 原田 英雄| 田中 淳太郎| 越智 浩二| 松本 秀次| 妹尾 敏伸| 出石 通博| 谷崎 勝朗|
抄録 膵炎のうちもっとも頻度が高いアルコール性膵炎(AIP)の疫学,臨床像および発生機序に関する従来の知見を総括した。AIPの大多数は慢性膵炎である。通常は長期にわたる多量の飲酒を背景に発症するが,遺伝的素因および食事因子も重要な役割を演じる。発症初期には血中膵酵素の上昇をともなう腹痛が病像を支配するが,進展すると膵外分泌不全による消化吸収障害と膵内分泌不全による糖尿病が病像を支配するようになる。アルコール性慢性膵炎は非アルコール性慢性膵炎にくらべて確診時にすでに進展した症例が多く,合併症が多く,進行が早く,予後が悪い。死亡の主たる原因は癌の併発と糖尿病の合併症で,膵炎の急性増悪発作がこれにつぐ。併発する癌のなかでは膵癌よりもむしろ上部気道および上部消化管の癌が多い。発生機序としてはDuctal-Plug説とToxic-Metabolic説が有力であるが,最近は細 胞内膵酵素活性化説とFree Radical説も注目をあびている。
抄録(別表記) This paper is to review the literature on the epidemiology, clinical pictures and etiopathogenesis of alcohol-induced pancreatitis (AIP). The incidence of AIP has been increasing worldwide, paralleling the increase in alcohol consumption. AIP manifests itself following a longterm consumption of large amounts of alcohol. There is no known threshold value of alcohol consumption in terms of the risk of developing AIP, although the logarithm of the risk of developing AIP is lineally correlated with the amount of alcohol intake. Why some alcoholics develop pancreatitis whereas others with equal consumption of ethanol are spared remains to be explained. Therefore, two additional factors are considered to play important roles in developing AIP : genetic predisposition and diet. The majority of AIP IS chronic pancreatitis (AICP), although a minority can be acute pancreatitis (AIAP). AIAP shows somewhat higher morbidity and mortality than the common variety of acute pancreatitis. If recovered from an attack, AIAP shows morphological and functional restoration. AICP manifests itself with an acute attack of abdominal pain, insidious onset of abdominal pam, or a pain-free variety. An acute attack in AICP resemble that m AIAP ; often these two can be differentiated only by follow-up studies. AICP shows no morphological and functional restoration, and often shows progressive deterioration. Abdominal pain with elevated serum pancreatic enzymes is a predominant clinical picture m the early stage of AICP, whereas in the late stage symptoms and signs deriving from exocrine insufficiency (maldigestion) and endocrine insufficiency (pancreatic diabetes) begin to dominate the clinical pictures. AICP is in the more advanced stage and shows more complications than nonalcoholic chronic pancreatitis at the time of diagnosis. In addition, AICP shows more rapid progress and higher morbidity and mortality. The incidence of microangiopathy in pancreatic diabetes resemble that in primary diabetes, being higher in patients with a longer history of diabetes, those on insulin treatment and those under poorer control. Main causes of death are development of cancer in the upper respiratory and gastrointestinal tract and diabetic complications (hypoglycemic shock, renal failure, and intractable pneumonia), and acute attack of pancreatitis leads to death less frequently. Ductal-Plug theory and classical Toxic-Metabolic theory are most popular to explain the pathogenesis of AIP ; however, increasing evidence has been reported that oxygen free radicals and intracellular activation of zymogens by lysosomal enzymes may be involved in the pathogenesis.
キーワード アルコール性膵炎 (Alcohol-induced pancreatitis) 慢性膵炎 急性膵炎
出版物タイトル 環境病態研報告
発行日 1991-08
62巻
開始ページ 52
終了ページ 70
ISSN 0913-3771
言語 Japanese
論文のバージョン publisher
NAID 120002307918
JaLCDOI 10.18926/15128
タイトル(別表記) Collagen degradation and in the pathogenesis of dieseases
フルテキストURL 066_078_084.pdf
著者 越智 浩二| 原田 英雄| Chowdhury Riaz| 山下 晴弘| 一村 光子| 田中 淳太郎| 妹尾 敏伸| 松本 秀次| 水島 孝明| 横田 聡| 光延 文裕| 谷崎 勝朗|
抄録 組織のコラーゲン沈着にはコラーゲン合成系と分解系の不均衡によって生ずる。従来,主としてコラーゲン合成系が注目されていたが,最近の研究の進歩により,コラーゲン分解系が重要な役割を演ずることが明らかになってきた。コラーゲンの分解系には細胞内と細胞外の二つの経路が存在する。それぞれcollagenolytic cathepsinおよびmatrix metalloproteinases( MMP)がコラーゲン分解能を有する重要な酵素である。その調節因子については細胞外の経路についての解明か進んでいる。MMPの遺伝子の発現にはサイトカインや成長因子が関与し,IL-1やTNF-αは強力な誘導因子である。一旦,遺伝子か発現すれば,MMPは合成され,細胞外に不活性型(latent form)で分泌される。不活性型のMMPが活性化する過程にはplasminogen activator inhibitorやtissue inhibitors of metalloproteinases(TIMP)などの阻害因子が存在し,MMP活性を調節する。TIMPの遺伝子の発現にもサイトカインや成長因子が関与する。MMPがTIMPを上回るような病態では組織破壊が,逆にTIMPがMMPを上回るような病態では綿維化が生ずる。コラーゲン分解能の障害が線維化の維持や不可逆性に関与することが推察される。
抄録(別表記) Fibrosis is the result of net accumulation of collagen in the organ. This may occur as a consequence of alterations in the synthesis of collagen, their degradation, or both. Recent investigations revealed that a decrease in collagen degradation plays a crucial role in fibrogenesis. Two pathways exist in collagen degradation : extracellular and intracellular. Each pathway has an important enzyme; that is, matrix metalloproteinases (MMP) and collagenolytic cathepsin, respectively. Collagenolytic activity is regulated at several levels. Expression of MMP and tissue inhibitors of metalloproteinase (TIMP), which act as inhibitors of MMP, is regulated independently by a number of cytokines and growth factors. MMP, which is synthesized in the cell, is secreted in a latent form. Activation of the latent MMP is controlled by TIMP and plasminogen activator inhibitor. TIMP also inhibits activated MMP which can degrade connective tissue matrices including collagens. In the condition where TIMP is predominant over MMP, activity of collagen breakdown is reduced, and consequently collagen deposition occurrs.
キーワード 線維化 (Fibrosis) コラーゲン (Collagen) TIMP (tissue inhibitor of metalloproteinase) MMP (matrix metalloproteinase)
出版物タイトル 岡大三朝分院研究報告
発行日 1995-09
66巻
開始ページ 78
終了ページ 84
ISSN 0918-7839
言語 Japanese
論文のバージョン publisher
NAID 120002307516
著者 原田 英雄|
発行日 1983-03-25
出版物タイトル 岡山大学温泉研究所報告
53巻
資料タイプ その他
JaLCDOI 10.18926/21104
タイトル(別表記) Effects of serial bathing on fatty acid composition of adrenal and serum cholesterol ester in rats
フルテキストURL pitsr_054_019_024.pdf
著者 妹尾 敏伸| 原田 英雄| 御船 政明| 森永 寛|
抄録 The effects of serial bathing (10 minutes bathing in a city water or hot spring in Misasa, 40℃, once daily for 1-4 weeks) on fatty acid composition of cholesterol ester of the adrenal glands and serum was studied in both normal and hypercholesteremic rats. Although the adrenal cholesterol ester levels were relatively unaffected in rats treated with serial bathing as well as non-treated rats, the proportion of 18 : 2 was increased in rats treated with hot spring bathing for 3-4 weeks. The serum cholesterol ester levels in both normal and hypercholesteremic rats tended to decrease after serial bathing for 3-4 weeks compared with non-treated rats. The fatty acid composition of serum cholesterol ester in normal rats was unaffected. The composition in hypercholesteremic rats showed an increase in the proportion of 16 : 1 and 18 : 1 and a decrease of 18 : 2 and 20: 4 compared with normal rats. When those of hypercholesteremic rats were treated with serial bathing for 3 weeks, particularly with hot spring bathing, the proportion of 16 : 1, 18: 2 and 20 : 4 showed a tendency to approach that in tormal rats. The findings indicate that serial hot spring bathing for 3-4 weeks, unlike city water bathing, exerts an influence on the fatty acid composition of cholesterol ester of the rat adrenal glands and it also improves the fatty acid compsition of serum cholesterolester of hypercholesteremic rats.
出版物タイトル 岡山大学温泉研究所報告
発行日 1984-03-25
54巻
開始ページ 19
終了ページ 24
ISSN 0369-7142
言語 Japanese
論文のバージョン publisher
NAID 120002310999
JaLCDOI 10.18926/21086
タイトル(別表記) Effect of serial bathing on circadian variation of plasma metabolites in rats
フルテキストURL pitsr_056_035_043.pdf
著者 妹尾 敏伸| 原田 英雄| 御船 政明| 森永 寛|
抄録 The effect of serial bathing (10-minute bathing in city water or Misasa hot spring, 40℃, once daily for one or four weeks) on the circadian variations of plasma metabolites was studied in three groups of rats : hot spring bathing rats, city water bathing rats and non-treated rats. Plasma obtained by decapitation at 8:00, 12:00, 16:00, 20:00 and 24:00 hours was analysed for catecholamines (CA), free fatty acids (FFA), cholesterol (C) and glucose. 1) Noradrenaline (NA) and adrenaline (A) were significantly lower at 24:00 hours with significantly lower 24-hour average concentrations and also with significantly different diurnal patterns in the 1-week hot spring bathing rats; in the 4-week hot spring bathing rats, lower 24-hour average concentrarion of A was the only significant finding. The results suggest the suppressive effect of hot spring bathing on the sympathetic system or pituitary gland-adrenal medulla; they also suggest the adaptation to hot spring bathing. 2) Free fatty acids were significantly higher in the 1-week hot spring bathing rats at 12:00 hours as compared with non-treated rats and city water bathing rats. The 4-week hot spring bathing rats showed concentration of FFA not different from the remaining two groups of rats. No significant difference was noted in diurnal patterns among the three groups of rats. The results suggest that the high FFA concentrations in the 1-week hot spring bathing rats are related to the physico-chemical constituents of the hot spring to some extent and that the rats adapt themselves to bathing during the 4-week preriod. 3) Cholesterol was significantly lower in the 4-week hot spring bathing rats as compared with non-treated rats and city water bathing rats; no different diurnal patterns were noted among the three groups of rats. The results suggest the suppressive effect of 4-week hot spring bathing on plasma cholesterol concentrations as reported previously by us. 4) No Significant difference was noted in concentrations as well as in diurnal patterns of plasma glucose among the three groups of rats. The results suggest that bathing has no significan effect on concentrations and diurnal patterns of plasma glucose in healthy rats.
出版物タイトル 岡山大学温泉研究所報告
発行日 1985-03-30
56巻
開始ページ 35
終了ページ 43
ISSN 0369-7142
言語 Japanese
論文のバージョン publisher
NAID 120002310969
JaLCDOI 10.18926/15090
タイトル(別表記) Gastro-biliary motility in patients with non-ulcer dyspepsia
フルテキストURL 067_075_078.pdf
著者 水島 孝明| 山本 良一| 松村 直樹| Chowdhury, Riaz| 加藤 匡宏| 越智 浩二| 田中 淳太郎| 原田 英雄| 横田 聡| 光延 文裕| 御舩 尚志| 谷崎 勝朗|
抄録 現在,上腹部不定愁訴の原因は特定されていない。その原因を解明するため,上腹部不定愁訴患者8人と健常対照者10人に対して液体食の胃排出能と,食事負荷による胆嚢収縮能を測定した。胃排出時間,胆嚢収縮能はいずれも両者に有意な差は認められなかった。健常対照者では胃排出時間と胆嚢収縮時間に有意な相関関係が認められたが,上腹部不定愁訴群では相関関係は認められなかった。上腹部不定愁訴の原因として胃・胆嚢協調運動障害の存在が示唆 された。
抄録(別表記) Subjective symptoms are quite similar between cystic duct syndrome (CDS) and non-ulcer dyspepsia (NUD) : epigastralgia, hypochondralgia and vague complaints in the upper part of the abdomen. Recently, there has been several reports suggesting that the cause of these disorders is postprandial dysmotility in the gallbladder and stomach. However, there has been no report suggesting incoordination of postprandial gastrobilialy motility as the cause of tha above mentioned complaints in these disorders. The aim of this study was to define the difference of postprandial gastrobiliary motility between patients with NUD and controls. Eight patients with NUD and 10 controls were studied. Gastric emptying time of liquid meal and gallbladder contraction were measured, simultaneously. There was no significant difference between study patients and controls when gastric emptying time and gallbladder contraction rate were compared in isolation. However, when these two parameters were assessed in combination, gastric emptying time was linearly correlated with minimum ballbladder contraction time in controls but not in patients. We conclude that the incoordination between gastric emptying and minimal gallbladder contraction may be one of the major causes of the symptoms in NUD.
キーワード 胃運動 (Gastric motility) 胆嚢運動 (Biliary motility) 不定愁訴 (indefinite complaint)
出版物タイトル 岡大三朝分院研究報告
発行日 1996-11
67巻
開始ページ 75
終了ページ 78
ISSN 0918-7839
言語 Japanese
論文のバージョン publisher
NAID 120002308012
著者 原田 英雄|
発行日 1973-08-30
出版物タイトル 岡山医学会雑誌
85巻
7-8号
資料タイプ 学術雑誌論文
著者 原田 英雄|
発行日 1973-08-30
出版物タイトル 岡山医学会雑誌
85巻
7-8号
資料タイプ 学術雑誌論文
著者 原田 英雄|
発行日 1973-08-30
出版物タイトル 岡山医学会雑誌
85巻
7-8号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/21124
タイトル(別表記) A case report of a patient with chronic pancreatitis successfully treated by endoscopic elimination of protein plugs
フルテキストURL pitsr_053_061_065.pdf
著者 武田 正彦| 田中 淳太郎| 高杉 潔| 原田 英雄| 万治 忠福| 森永 寛| 鶴見 哲也| 藤井 靖久|
抄録 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.
出版物タイトル 岡山大学温泉研究所報告
発行日 1983-03-25
53巻
開始ページ 61
終了ページ 65
ISSN 0369-7142
言語 Japanese
論文のバージョン publisher
NAID 120002311007
JaLCDOI 10.18926/21123
タイトル(別表記) Role of endoscopic elimination of protein plug in the treatment of chronic pancreatitis
フルテキストURL 053_057_060.pdf
著者 田中 淳太郎| 武田 正彦| 高杉 潔| 原田 英雄| 万治 忠福|
抄録 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.
出版物タイトル 岡山大学温泉研究所報告
発行日 1983-03-25
53巻
開始ページ 57
終了ページ 60
ISSN 0369-7142
言語 Japanese
論文のバージョン publisher
NAID 40000321176
JaLCDOI 10.18926/14989
タイトル(別表記) A case of eosinophilic gastroenteritis with stenosis in the colon
フルテキストURL 068_064_070.pdf
著者 水島 孝明| 越智 浩二| 松村 直樹| 加藤 匡宏| 妹尾 敏伸| 原田 英雄| 御舩 尚志| 光延 文裕| 谷崎 勝朗|
抄録 大腸に全周性狭窄をきたした好酸球性胃腸炎の1例を報告した。症例は54才の女性で,腹痛と下痢を主訴に来院した。上部消化管検査では異常を認めなかったが,下部消化管造影検査と大腸内視鏡検査で横行結腸の全周性狭窄を認め,生検にて大腸粘膜の好酸球浸潤を認めた。貝料理の摂取にて腹痛発作が出現したが,原因抗原は同定できなかった。貝類の摂取を避けることにより,症状は消失し,末梢血液中の好酸球増多は消失した。本邦ではこれまでに124例 の報告があるが,大腸に全周性の狭窄をきたす症例は稀であり,文献的考察を加え報告する。
抄録(別表記) We report a case of eosinophilic gastroenteritis with a stenosis in the transverse colon. A patient, 54 year-old-woman, presented to our clinic with abdominal pain and diarrhea. Esophagogastric endoscopy and biopsy were normal. Contrast barium enema examination and colonic endoscopy showed a stenotic segment in the transverce colon. Biopsy specimens obteind from the stenotic segment revealed moderate eosinophilic infiltration in the colonic mucosa. Oral intake of sea shells exacerbated her symptoms. Avoiding sea shells has resulted in the disappearance of symptoms and peripheral blood eosinophilia. The present case was discussed in comparison with the 124 cases heretofore reported in Japan.
キーワード 好酸球性胃腸炎 (eosinophilic gastroenteropathy) 大腸 (colon) 狭窄 (stenosis)
出版物タイトル 岡大三朝分院研究報告
発行日 1997-12
68巻
開始ページ 64
終了ページ 70
ISSN 0918-7839
言語 Japanese
論文のバージョン publisher
NAID 120002308243
JaLCDOI 10.18926/11705
タイトル(別表記) Clinical study on polypoid lesions of the colon
フルテキストURL 061_036_040.pdf
著者 越智 浩二| 原田 英雄| 松本 秀次| 妹尾 敏伸| 田中 淳太郎| 立花 英夫| 穐山 恒雄| 中井 睦郎|
抄録 1986年4月から1990年2月末までの間に岡山大学医学部附属病院三朝分院で経験した早期大腸癌を含む大腸ポリープ90例(107病変)を対象に,年齢,臨床症状,便潜血反応,病変存在部位について検討を行い,以下の成績を得た。(1)大腸検査総数の22.4%にポリープが発見された。ポリープの77%は腺腫,5%は腺癌(早期癌)であった。(2)便潜血反応はポリープ例の75.9%に陽性であり,右側大腸ポリープでの陽性率は高かったが,S状結腸および直腸ポリープでは70%程度であった。(3)若年者では右側結腸にポリープが発見されることは稀であるが,50才以上では18%程度に認められた。高齢者では右側結腸も内視鏡で検査することが重要である。(4)免疫学的便潜血検査法の導入により大腸ポリープの発見効率が改善するものと考え られた。
抄録(別表記) This report is concerned with clinical study on 90 patients with polypoid lesions (107 lesions) which we have encountered in Misasa Hospital, Okayama University in the past 4 years. Following results were obtained : (1) Polypoid lesions were detected in 90 (22.4%) and advanced adenocarcinoma (mostly resectable) in 22 (5.5%) of 402 patients who were examined by sigmoidoscopy and barium enema ; (2) Histological examination of the polypoid lesions showed adenoma in 77.2%, hyperplastic polyp in 8.7%, inflammatory polyp in 7.6%, neurinoma in 0.3% and early cancer (adenocarcinoma) in 5.4% ; (3) It was impossible to differentiate benign and malignant polypoid lesions on the basis of endoscopic and X-ray findings alone ; (4) Forty-two percent of the polypoid lesions was detected in the sigmoid colon, 30% in the rectum, 16.8% in the descending colon, 9.3% in the ascending colon, 0.9% in the caecum ; (4) Patients younger than 50 years of age showed only one polypoid lesion in the right hemicolon, whereas elder patients showed as many as 17 polypoid lesions ; (5) Among the 90 patients with polypoid lesions, 40 presented with abdominal pain, 20 with no symptoms (annual health check-up), 17 with irregular bowel habits, and 10 with melena ; (6) Among the 90 patients, occult blood in stool was positive in 75.8% with a lower positive rate in the lesions of the sigmoid and rectum ; (7) Among 5 asymptomatic patients with lesions and with a negative hemoccult test, 3 patients with a polypoid lesion were examined because of the patients' request, 1 patient with a polypoid lesion because of a positive family history, and the remaining 1 patient in a search for the primary lesion of the metastatic liver cancer ; (8) Among patients with a positive hemoccult test, the detection rate of polypoid lesions was 41.9% with use of an immunological method, whereas it was 19.7% with use of a chemical method. In conclusion, (1) detection of colonic polypoid lesions can lead to the detection of early cancer, although only histological examination can confirm the accurate diagnosis ; (2) a hemoccult test in stool with an immunological method is an effective method for screening asymptomatic colonic polypoid lesions, although it must be admitted that negative results may occasionally occur ; (3) macroscopic observation of the stool mass is important before sampling, because lesions of the sigmoid colon or the rectum may show scanty blood only on the limited area of the surface of the stool ; (4) patients elder than 50 years of age should be examined more carefully for the whole colon preferably with an endoscope, because they show a high incidence of small polypoid lesions in the right hemicolon.
キーワード 大腸ポリープ (Polyp of the colon) 大腸早期癌 (Early cancer of the colon)
出版物タイトル 環境病態研報告
発行日 1990-09
61巻
開始ページ 36
終了ページ 40
ISSN 0913-3771
言語 Japanese
論文のバージョン publisher
NAID 120002313590
JaLCDOI 10.18926/15089
タイトル(別表記) Usefulness of retinol binding protein as a marker for the assessment of nutritional uptake for the preparation of colonosocpy
フルテキストURL 067_071_074.pdf
著者 加藤 匡宏| 蓮岡 英明| 越智 浩二| 水島 孝明| Chowdhury Riaz| 松村 直樹| 山本 良一| 田中 淳太郎| 原田 英雄| 穐山 恒雄| 横田 聡| 光延 文裕| 谷崎 勝朗|
抄録 大腸内視鏡検査の前処置を栄養面から評価する目的で前処置前後にrapid turnover proteinである血中レチノール結合蛋白の変動を検討した。前日に普通食を用い,当日ニフレックを使用した10例,検査1日前に低残渣食を用いた27例,通常の前処置では良好な腸管洗浄が得られないために検査前2日間低残渣食を用いた27例の3群について,前処置開始前と検査終了後に血中レチノール結合蛋白の変動をみたところ,検査前2日間低残渣食服用群で有意の低下を認めた。前日普通食群では検査前後で変化を認めず,1日低残渣食服用群では低下傾向を認めたが,有意差は認めなかった。これまで前処置の成否は腸管洗浄度の面で評価されてきたが,血中レチノール結合蛋白を目標として用いることにより栄養面から評価することができることが考えられた。
抄録(別表記) The objective of this study was to evaluate the usefulness of retinol binding protein (RBP), one of rapid turnover proteins, for the assessment of nutritional aspect of the preparation for colonoscopy. Blood samples were drawed before the preparation and after the colonoscopic examination and serum RBP was determined by laser nephrometory. Group A consisted of 10 patients who were administered intestinal lavage solution (Niflec) without no low residual diet. Group B consisted of 27 patients who were adminstered low residual diet for 1 day. Group C consisted of 27 patients who were administered low residual diet for the two consecutive days before colonosocopic examination with intestinal lavage solution and magnesium citrate because sufficient cleanup of intestine were not expected by using the ordinary preparations. The values of serum RBP significantly decreased in group C after the preparation although no significant changes were observed in group A and Group B. We emphasized in estimating the preparation for the colonoscopy assessment of nutrition using serum RBP was needed as well as colonic cleaning.
キーワード レチノール結合蛋白 (retinol binding protein) 大腸内視鏡 (colonoscopy) 前処置 (preparation) 栄養評価 (nutritional assessment)
出版物タイトル 岡大三朝分院研究報告
発行日 1996-11
67巻
開始ページ 71
終了ページ 74
ISSN 0918-7839
言語 Japanese
論文のバージョン publisher
NAID 120002307681
JaLCDOI 10.18926/19797
タイトル(別表記) Clinical evaluation of co-examination by sigmoidoscopy and barium enema study for early diagnosis of colon cancer
フルテキストURL 060_039_046.pdf
著者 越智 浩二| 石橋 忠明| 松本 秀次| 妹尾 敏伸| 田中 淳太郎| 原田 英雄| 穐山 恒雄| 中井 睦郎| 林本 加奈枝|
抄録 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。
抄録(別表記) 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.
キーワード 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)
出版物タイトル 環境病態研報告
発行日 1989-07
60巻
開始ページ 39
終了ページ 46
ISSN 0913-3771
言語 Japanese
論文のバージョン publisher
NAID 120002309136
JaLCDOI 10.18926/15161
タイトル(別表記) Clinical studies on polypoid lesions of the colon.
フルテキストURL 065_101_106.pdf
著者 高田 一郎| 貴谷 光| 御舩 尚志| 光延 文裕| 梶本 和宏| 松村 正| 横田 聡| 谷崎 勝朗| 越智 浩二| 原田 英雄| 穐山 恒雄| 中井 睦郎|
抄録 1990年4月より1994年3月末までの間に岡山大学医学部附属病院三朝分院で経験した早期大腸癌を含む大腸ポリープ88例を対象に,病理組織診断,性別,年齢構成,存在部位,精査動機について検討を行い,以下の成績を得た。(1)ポリープの69.2%は腺腫,13.2%は腺癌(早期癌)であった。(2)男女とも加齢による大腸ポリープ及び大腸癌の頻度の増加がみられた。(3)50歳未満の若年者では右側結腸にポリープが発見されることは稀であったが50歳以上では6.5%に認められ,高齢者における積極的なtotal colonoscopyによる観葉が重要であることが再確認された。(4)精査動機では便潜血陽性が最多を占め,便潜血は大腸ポリープのスクリーニングにおいて有用であることが示された。またフォローアップ目的に大腸ファイバーを施行しポリープや早期癌を発見した例も多く,フォローアップの必要性が示唆された。
抄録(別表記) Polypoid lesions, taken by a colon fiberscope, were examined in 88 patients with polyp, who were admitted to Misasa Medical Branch, Okayama University Medical School for last 4 years. (1) Pathohistological examination of the polypoid lesions resulted in 69.2% of adenoma and 13.2% of adenocarcinoma (early cancer) ; (2) 35.5% of the polypoid lesions was detected in the sigmoid colon, 32.7% in the rectum, 16.8% in the transverse colon, 4.7% in the descending colon, 3.7% in the caecum, 1.9% in the ascending colon ; (3) The number of patients with polypoid lesion or colon cancer was increased with aging ; (4) Patients with the age under 50 years did not have polypoid lesion in the right hemicolon, while 6.5% of elder patients over age 50 has polypoid lesions in the right hemicolon ; (5) Occult blood in stool was the most popular motivation for receiving colonoscopic examinations ; (6) The second popular motivation for colonoscopy was for follow up after previous examinations. These results suggest that patients with age over 50 should be examined more carefully by total colonoscopy, and a hemoccult test in stool is an effective method for screening colonic polypoid lesions and after detection of polypoid lesions or polypectomy, reexamination by total colonoscopy is important at regular intervals.
キーワード 大腸ポリープ (Polyp of the colon) 大腸早期癌 (Early cancer of the colon) 便潜血 (Occult blood in stool)
出版物タイトル 岡大三朝分院研究報告
発行日 1994-09
65巻
開始ページ 101
終了ページ 106
ISSN 0918-7839
言語 Japanese
論文のバージョン publisher
NAID 120002307396
JaLCDOI 10.18926/21107
タイトル(別表記) An evaluation of pancreatographic findings in the differential diagnosis of chronic pancreatitis and pancreatic cancer
フルテキストURL pitsr_054_039_041.pdf
著者 田中 淳太郎| 越智 浩二| 入江 誠治| 武田 正彦| 原田 英雄|
抄録 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.
出版物タイトル 岡山大学温泉研究所報告
発行日 1984-03-25
54巻
開始ページ 39
終了ページ 41
ISSN 0369-7142
言語 Japanese
論文のバージョン publisher
NAID 120002310981