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68 巻, 3 号
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副甲状腺ホルモンの合成・分泌とその調節尾形 悦郎1992 年 68 巻 3 号 p. 119-127
発行日: 1992/03/20
公開日: 2012/09/24
ジャーナル フリーPDF形式でダウンロード (6804K) -
研究の現況と今後の課題小島 至1992 年 68 巻 3 号 p. 128-133
発行日: 1992/03/20
公開日: 2012/09/24
ジャーナル フリーCalcium ion acts as an intracellular messenger of various types of extracellular signals including hormones, neurotransmitters, cytokines and growth factors. Recent advances in the research of the calcium messenger system have provided informations as to the structure and function of many proteins involved in the messenger system. Also, technical advances in the measurement of the dynamics of calcium ion in a small cell have made it possible to better understand the role of calcium in the activation of the cell. In the present review, a picture of the calcium messenger system is presented.抄録全体を表示PDF形式でダウンロード (641K) -
中尾 一和1992 年 68 巻 3 号 p. 134-142
発行日: 1992/03/20
公開日: 2012/09/24
ジャーナル フリーThe natriuretic peptide system consists of at least three endogenous ligands: atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP), and three receptors, ANP-A receptor (guanylate cyclase A), ANP-B receptor (guanylate cyclase B) and clearance receptor (C receptor).
ANP, the prototype of natriuretic peptides, is mainly produced in the atrium and secreted into the circulation as a cardiac hormone. ANP is also produced in the ventricle and in the central nervous system. BNP, first isolated from the porcine brain, has a marked divergence in its molecular size and sequence among species. In humans and rats, the major site of production of BNP is the ventricle of the heart. BNP is also secreted into the circulation as a cardiac hormone. The plasma BNP level in normal subjects is approximately one sixths of the plasma ANP level; however, the plasma BNP level markedly increases in heart failure, renal failure and hypertension and the augmentation of the BNP secretion is much larger than that of the ANP secretion. In addition, clearance of BNP from the circulation is slower than that of ANP. Furthermore, BNP is secreted more urgently than ANP in acute heart failure. CNP distributes mainly in the central nervous system and pituitary gland. No significant amount of CNP is detectable in the heart and plasma. Thus, CNP is a local regulator rather than a cardiac hormone.
Three natriuretic receptors have ligand selectivity. The rank order in potency for cyclic GMP production via ANP-A receptor is ANP?BNP>>CNP, while that via ANP-B receptor is CNP>ANP?BNP. The rank order of binding affinity for C receptor is ANP>CNP>BNP.
The complicated natriuretic peptide system is implicated in the control of body fluid and blood pressure in endocrine and paracrine fashions.抄録全体を表示PDF形式でダウンロード (865K) -
佐藤 正幸, 広松 雄治, 田中 希代子, 野中 共平, 小島 和行, 西村 浩, 西田 博1992 年 68 巻 3 号 p. 143-153
発行日: 1992/03/20
公開日: 2012/09/24
ジャーナル フリーFifteen patients with Graves' ophthalmopathy (GO) were treated with intravenous methylprednisolone (steroid pulse therapy, lg daily for 3 days a week, 2-4 times) and followed up by ophthalmological assessment and magnetic resonance imaging (MRI). The signal intensity of enlarged eye muscle and retrobulbar fat was examined with MRI at 0.5T with short inversion time inversion recovery (STIR) sequences. The signal intensity of eye muscle and retrobulbar fat tissue in STIR was evaluated as the ratio to cerebral substantia alba (signal intensity ratio). The thickness of enlarged eye muscle was measured by T1- weighted coronal images.
The signal intensity ratios of enlarged eye muscle of GO patients were significantly higher than those of eight normal subjects. Although the signal intensity ratios of muscle and retrobulbar fat before therapy were not related to the severity of clinical findings of GO assessed by ophthalmopathy index, the initial signal intensity ratios of eye muscle and retrobulbar fat of ten patients with improved clinical findings of GO after steroid pulse therapy tended to be higher than those of five patients without improvement by the therapy. After the therapy the signal intensity ratios of muscle and retrobulbar fat were significantly decreased in ten patients with favorable response. Our data suggested that high signal intensity in STIR may reflect edema caused by acute inflammation associated with GO.
In conclusion, MRI may be a useful tool for determining the indication and prognosis of steroid pulse therapy. We strongly recommend measuring the signal intensity of eye muscle as well as muscle thickness in MRI to evaluate the activity of GO.抄録全体を表示PDF形式でダウンロード (1378K) -
石突 吉持, 広岡 良文, 村田 善晴, 富樫 和美1992 年 68 巻 3 号 p. 154-165
発行日: 1992/03/20
公開日: 2012/09/24
ジャーナル フリーWhether with the passage of time subacute thyroiditis leads to hypothyroidism remains to be determined. Therefore, we evaluated the thyroid function including TRH test of 66 patients with a previous history of subacute thyroiditis and age-matched control subjects with special reference to the measurement of inorganic iodide.
The patients were divided into 3 groups according to time lapse since the occurrence. Group 1 consisted of 24 cases followed up for 4 to 24 months. Sixteen cases in group 2 had their courses from 2 to 5 years, and group 3 was composed of 26 cases over the past 5 to 30 years. We selected 169 subjects without history of subacute thyroiditis and divided them into three control groups matched for age, each corresponding to the patient groups (group la, 2b and 3c, respectively).
41.7% and 29.2% of cases in group 1 had high basal levels of serum TSH (>3.6μU/ml) and ΔTSH (the increment of TSH after TRH,>46.8μU/ml). In group 2, levels of serum T3 and T4 returned to normal ranges. However, in group 3, significant higher elevations in TSH and ΔTSH than those in group 3c were observed, and the T4, FT4, T3 and FT3 levels were lower than those of group 3c (p<0.01 and p<0.05, respectively). 42.3% of cases in group 3 showed high TSH, and there were 4 cases with clinical hypothyroidism.
Among the cases studied, a significant negative correlation (p<0.01) between levels of TSH and T4 was observed, while a correlation between TSH and L TSH was positive (p<0.001). High levels of serum inorganic iodide were observed in 6.1 of cases and a correlation between inorganic iodide and TSH was significantly positive (p<0.01) not only in patients with subacute thyroiditis, but also in the control subjects.
Antithyroid autoantibodies were detected in 42.4% of all the cases with subacute thyroiditis and also in 45.6% of all the controls. In group 3, MCHA was detected in 64.5% of the cases, and the frequency was higher than that of group 3c as well as that of 25% in group 2 (p<0.01), respectively. In 15.4% of the cases in group 3, the titers of MCHA were more than 402, and the titers of MCHA were significantly higher in patients with a long-term period after the onset of subacute thyroiditis than those with a short-term period.
The levels of TSH and A TSH in patients with positive MCHA in group 3 were significantly higher than those in patients with negative MCHA in group 2.
In conclusion, it was suggested that in Japanese cases with subacute thyroiditis who took iodine-rich food, there might be a slow aueleration in the destructive process in the thyroid, resulting in the development of hypothyroidism.抄録全体を表示PDF形式でダウンロード (1102K) -
岡 暢之, 野津 和巳, 正木 洋治, 古家 寛司, 大国 智司, 加藤 讓1992 年 68 巻 3 号 p. 166-173
発行日: 1992/03/20
公開日: 2012/09/24
ジャーナル フリーA 27-year-old woman with type 1 diabetes mellitus was admitted to the Shimane Medical University Hospital because of secondary amenorrhea. She had been treated with insulin since July, 1986. Fasting plasma glucose and HbA1c levels were controlled within normal limits. However, body weight gradually decreased and amenorrhea started in 1988. Physical examination revealed emaciation with BMI of 17.3. Basal levels of plasma T3, somatomedin C, LH, FSH and estradiol levels were low, whereas HGH levels were slightly elevated. Plasma LH markedly increased in response to LHRH administration. She was diagnosed as having weightloss-related hypothalamic amenorrhea. Induction of ovulation was not obtained with clomiphene citrate. Treatment with subcutaneous pulsatile administration of LHRH (20μg every 120 min) resulted in an increase in plasma levels of LH, FSH and estradiol, which was accompanied by ovulation and corpus luteum formation. Further treatment with pulsatile LHRH administration was followed by conception. Two gestational sacs were detected by ultrasonography. One of them was absorbed at the early stage of pregnancy. She was delivered of one healthy female infant without complications.
These findings suggest that it is important not only to control plasma glucose levels but to keep the appropriate weight and support the psychological aspects of the subject in the treatment of diabetes mellitus. Subcutaneous pulsatile LHRH therapy may be effective for the induction of ovulation in clomiphene-resistant hypothalamic amenorrhea; however, it will be necessary to solve the problem of dosage and the interval of LHRH administration in the future.抄録全体を表示PDF形式でダウンロード (717K)
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