日本リウマチ・関節外科学会雑誌
Online ISSN : 1884-9059
Print ISSN : 0287-3214
ISSN-L : 0287-3214
5 巻, 3 号
選択された号の論文の29件中1~29を表示しています
  • 杉岡 洋一
    1986 年 5 巻 3 号 p. 267-268
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
  • 富原 光雄, 田中 清介, 広藤 栄一, 松倉 登
    1986 年 5 巻 3 号 p. 269-275
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Thrity - two patients with surgically treated osteoarthritis of the hip joints were evaluated for lumbar scoliosis. Twenty of them (63%) had scoliosis of 4 degrees or more. Preoperative X - rays after correcting of leg length discrepancy and pelvic obliquity revealed that there had been no change in the lumbar scoliosis in 7 patients. What the changes of lumbar scoliosis and pelvic obliquity will be after surgery of the hip joint should be estimated preoperatively.
  • 奥村 秀雄, 山室 隆夫, 上尾 豊二, 笠井 隆一, 飯田 寛和, 石田 勝正
    1986 年 5 巻 3 号 p. 277-284
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Bateman U.P.F. hip arthroplasties with acetabular reaming were performed on one male and 19 female relatively young patients (average age of 41.3) with severe osteoarthritis according to carefully considered indications. Bilateral operations were not done on any of them.
    In the procedure, the acetabulum was deepened with a reamer that was the same size as the outer head, and an outer head as large as possible was used. Severely dysplastic hips received on acetabular bone graft. Sufficient active exercise of joints and non-weight bearing activity were carefully continued in postoperative care.
    Clinical evaluation done by the criteria of the Japanese Orthopaedic Association revealed a score for five years of about 80, compared with 41 before operation. The scores for pain and range of motion improved within one year, but those for walking ability improved slowly over a 3-year period. Patients with acetabular bone graft had scores the same as those without bone graft had.
    Intra-and post-operative complications of infection, dislocation, fracture and neurovascular injury were not observed. In X-ray examination, a demarcation line was observed around the outer head in patients having a good clinical score. Migration of the outer head was not observed in anyone.
  • 高島 義裕, 宗広 忠平, 松本 忠美, 松沢 仁, 相良 光貞, 横川 明男, 末吉 泰信, 竹内 尚人, 野村 進, 中村 孝, 林 正 ...
    1986 年 5 巻 3 号 p. 285-290
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Aseptic loosening of implants is now the most serious problem in total hip arthroplasty. Failure at the cement-bone interface is frequently seen when bone cement is used. For the purpose of preventing aseptic loosening, cementless implants are being used in increasing number. Thirteen total hip arthroplasties with PCA cementless implants were performed during the period of January 1985 to October 1985. In eight of the cases followed up for over three months, no clinical or radiolographical failure was observed.
  • ―5年以上追跡した100関節の検討―
    川内 邦雄
    1986 年 5 巻 3 号 p. 291-304
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Alumina ceramic has been tried out as the material for the head of the femoral stem instead of the former H.D.P and metal combination, using a Weber-Stuhmer type with a 32mm diameter head on 433 joints. The longest clinical follow-up is 7 years.
    The results with 100 joints more than 5 years after operation were shown to be quite good by the J.O.A score. Clinical wear rates of 0.09mm/year is also satisfactory.
    We believe that by the use of alumina ceramics, the durability of T.H.R. will be improved and the age indication expanded.
  • 宮本 繁仁, 井上 哲郎, 串田 一博, 岡田 雅仁, 出口 知二, 山崎 薫, 西村 信啓, 岡本 庄造, 小関 孝夫
    1986 年 5 巻 3 号 p. 305-312
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    We analyzed 30 Bateman Universal Proxymal Femur (UPF) endoprostheses by clinical and radiographic examination. Of these 24 had had subcapital fracture (group 1), and 5 had had aseptic necrosis of the femoral head and 1 was of a bone tumor of the femoral head (group 2) . The patients were followed up over 3 years (mean 4 years, 3 months) . One had developed infection. The results in the 30 hips were evaluated by the JOA hip score; group 1 had a score of 81.3, and group 2 are of 83.3.
    Radiographic evalution showed that no patient had proxymal migration, 5 patients had distal migration, 5 patients had ectopic ossification, and 8 patients had clear zone enlargement.
    We concluded that the Bateman UPF is useful in the treatment of subcapital fracture in older patients and for those with aseptic necrosis of the femoral head.
  • 岩崎 安伸, 中野 圭一郎, 川井 和夫, 広畑 和志
    1986 年 5 巻 3 号 p. 313-319
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    The pathomechanism of rapidly destructive coxarthrosis (RDC) is unclear and controversial. We treated surgically two patients who seemed to have RDC in the early stage. X-ray examination before surgery had revealed the disappearance of joint space within two months. One patient was a 65 year-old female and the other a 74 year-old female. Their synovia and femoral heads were examined grossly and microscopically.
    We found that the joint cartilage was almost intact except the part of the weight-bearing area where the articular cartilage of the femoral head was lost and that the subchondral bone showed osteonecrosis. It would appear that the rapid loss of joint space in these two cases of RDC might result from avulsion of cartilage attached to subchondral necrotic bone.
  • 山本 武, 松倉 登, 松波 義文, 北野 安衛, 山根 敏彦, 永田 行男, 田中 清介, 生田 稔郎, 乾 保之
    1986 年 5 巻 3 号 p. 321-327
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    We have already reported that the results of the surgical treatment for trochanteric fractures of the femur with Ender nailing and Kuntscher condylo -cephalic nailing were nearly the same. However, in the Kuntscher condylo - cephalic nailing group, we found more cases with problems with rotation, and in the Ender nailing group more shortening and varus deformity cases.
    In order to investigate which method is superior biomechanically, compression stress tests and rotation stress tests were studied with the strain gauge method using cadaver wet bones. A two-legged stance method was taken. We used a 8mm Kuntscher nail and three 4mm Ender nails; one antevevsion nail, one varus nail and one standard nail. After that we osteotomized the femoral models through trochanters and made a stable type model, and an unstable type model according to Evans' classification, type 1 group 4.
    Two displacement transducers were fixed over the osteotomized site, one anteromedially, one posteromedially. There were no obvious differences between Ender nailing and Kuntscher nailing in compression stress tests. But in rotation stress tests, Ender nailing was slightly superior.
    It could be concluded that under such stress, the three diverged elastic Ender nails holds the proximal fragment better than the one 8mm clover-shaped Kuntscher nail.
  • 川上 宏治, 山本 龍二, 筒井 廣明, 安楽 岩嗣, 三原 研一, 今里 有紀彦
    1986 年 5 巻 3 号 p. 329-332
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Though recurrent subluxation of the shoulder is not so rare, its pathology is seldom recognized. We operated on 40 cases of it and found that “Bankart lesion” was the most common pathological area. An injured labrum and capsule were relatively frequent in the middle or superior portions of the glenoid. The results after operation by the Bankart procedure in 36 cases and the Oudard-Iwahara procedure in 4 cases were all exellent or good with one exception. That patient complained of pain when he tried to move his shoulder in flexion or abduction. 69% of the our cases returned to doing the sports which they had done before the operation.
  • 小野 佳夫, 近藤 真章, 北村 公一, 中野 昇, 中野 達
    1986 年 5 巻 3 号 p. 333-337
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    A follow-up study of 33 rotator cuff tears treated surgically was reported. Painless full motion was obtained in 21 patients. 9 patients complained of a dull ache after working, or in cold weather, but the nature of the pain was not severe and it was diminished by only taking a rest. When there was proof of a complete tear of the rotator cuff, we recommended operative treatment as soon as possible, because the surgical procedure was easier and post-operative course smoother for a fresh rotator cuff tear than for an old one.
  • 近藤 憲二, 山本 博司, 貞廣 哲郎, 河内 通, 近藤 宗昭, 田辺 暁人
    1986 年 5 巻 3 号 p. 339-345
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    The results of operative repairs of chronic tears of the rotator cuff in 28 patients were reviewed retrospectively. The mean follow-up time was 18 months. All the patients had failed to respond to conservative treatment and had persistent pain, weakness or loss of active motion. The average age at the time of repair was 59 years (range 42 to 73 years) . The tear of the rotator cuff was classified according to its defect size. There were small tears (2 centimeters or less) in 12 shoulders, large tears (greater than 2 centimeters) in 10 shoulders, and degenerative extensive tear in 6 shoulders.
    The type of repair performed was dependent on the direction tissue was torn in and the amount of loss of tendon substance. In 12 shoulders, repair was attempted by suturing tendon to tendon. MacLaughlin's procedure was done in 10 shoulders. In the 6 degenerative extensive tears, the trapezius muscle was transferred under the acromion to the humeral head in 5 shoulders and the deltoid muscle was transferred in one shoulder. In addition, anterior acromioplasty was performed in all patients to decompress the subacromial space.
    There was slight pain in 6 shoulders and moderate pain in 3 shoulders postoperatively, although all patients had persistent pain on motion preoperatively. The average range of motion improved 33 degress in flexion and 40 degrees in abduction, though the external rotation was not improved much. Muscular strength recovered to about 80% of the sound side except in the cases with a degenerative extensive tear. In them muscular strength was 33.2% of the sound side.
    According to Wolfgang's rating system, the results were excellent or good in 85.6% (24 patients) and fair or poor in 14.4% (4 patients) .
    Our arthroscopic research showed that elderly patients with a large and long standing tear had advaced degenerative changes in other shoulder structures. In such patients rotator cuff repair should be considered to be shoulder joint reconstruction. And further the exact shoulder pathomechanics in degenerative extensive tears should be understood so as to obtain better results. The treatment of degenerative extensive tear with respect to cuff tear arthropathy is now so difficult that it's surgical repair requires careful consideration and better surgical procedures for it should be developed.
  • 高倉 義典, 青木 孝, 杉本 和也, 海野 正登, 山下 正道, 勝井 建彦, 北田 力, 増原 建二
    1986 年 5 巻 3 号 p. 347-352
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Osteoarthritis of the ankle joint is recognized to be a relatively rare condition compared to other weight-bearing joints. Treatment for it in the early stage is the application of a shoe-insert or surgical repair of the lateral ligament. In the late stage, total ankle replacement or joint fusion is indicated. But treatment in the intermediate stage is difficult and controversial. In our clinic, we tried low tibial osteotomy on seven patients, two male and five female, who all showed a varus tilt of the distal joint surface of the tibia on an anteroposterior X-ray view and increased inclination of the distal joint surface of the tibia on a lateral view. Valgus osteotomy was done, with a few degrees of over-correction, for these cases. The average follow-up periods after operation was 2 years, ranging from 0.5 to 4.5 years, and results were satisfactory in all.
  • 西岡 淳一, 牛山 敏夫, 井上 康二, 仲谷 吉記, 七川 歓次
    1986 年 5 巻 3 号 p. 353-357
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    The indication of total ankle replacement (TAR) was discussed based on the results of using it on ten rheumatoid ankle and foot disorders. After TAR, ankle pain disappeared both at rest and while moving, and the activity of patients, especially in their gaits, was raised in various forms. Wheelchair patients became walkers with or without crutches, and walkable distances became much longer and pain free. The results of gait analysis by distribution of sole pressure followed the changes of walking ability and showed almost normal footprint patterns. These results indicate that TAR is one of the useful reconstructive managements for painful rheumatoid foot and ankle disorders.
  • 桜井 武男, 小沼 文紀, 岸 和司, 山田 晴康, 井上 博, 佐野 潔, 鈴木 庸介, 磯 武信
    1986 年 5 巻 3 号 p. 359-362
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Though the indications for total ankle replacement are controversial, it has been proposed as an alternative to arthrodesis. It is designed to preserve a functional range of motion and does not necessitate a long period of immobilization in a cast.
    From 1980 to 1985 we replaced ten ankles in seven patients with rheumatoid arthritis. The average follow-up time was 19 months.
    There was relief of pain and improvements in walking distance. But the gains in range of motion were poor.
  • 上野 敦弘, 山中 健輔, 石橋 庸司, 藤田 彰
    1986 年 5 巻 3 号 p. 363-367
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    In 119 patients with classical and definite rheumatoid arthritis, clinical and X-ray findings of the foot were examined. In a majority of them, plantal callosity was found in the second and third metatarso-phalangeal joints and more frequently in patients with normal medial arches than in those with flat feet.
    Surgical treatment for 16 forefeet with painful deformities in 8 patients was carried out. In 6 patients the fat pad of the forefoot became wider after resection arthroplasty of the metatarso-phalangeal joints (Leliever's procedure) .We thought that this was the major factor of the relief of forefoot pain. Recurrence of painful deformities was found in one patient who had received insufficient resectioning.
  • 森尾 泰夫, 上平 用, 大月 健二, 林 正郎, 倉信 耕爾, 林 寛一
    1986 年 5 巻 3 号 p. 369-374
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Resection arthroplasties of the metatasophalangeal joint were performed in 31 feet of 21 patients who had rheumatoid arthritis. Kates-Kessel-Kay arthroplasties were performed in 23 feet (16 cases), Clayton procedures in 5 feet (4 cases) and Keller procedures in 3 feet (2 cases) . The follow-up periods averaged 4.3 years.
    The results were almost satisfactory with the Kates-Kessel-Kay and Clayton procedures, due to the relief of pain in spite of the recurrence of hallux valgus and hammer toe deformities. The Keller operation was the only available method for hallux valgus but in the course of RA suffering metatarso-phalangeal disorders of other toes progressed and metatarsalgia of other toes occurred.
    For the purpose of the prevention of hallux valgus recurrence, we are now trying a Kates-Kessel-Kay procedure modified by transferring the adductor hallucis and flexor hallucis brevis to the 1st metatarsal excision stump.
  • 堀内 静夫, 小見渕 伸正, 岡本 連三, 腰野 富久
    1986 年 5 巻 3 号 p. 375-383
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    The forefoot deformities of hallux valgus, claw toes and splayfoot are often encountered in patients who have had rheumatoid arthritis for a long time, and they give the patients great discomfort. Lelievre's procedure, one of the resection arthroplasties, is a useful operative method to correct these deformities and to obtain better function.
    Twenty-two operations were performed in 16 patients using the Lelievre's procedure. Among them, 18 feet of 13 patients were available for follow-up; the average age of the patients was 52 years and the average follow-up period was 4 years and 8 months. All of them were women classified as classical RA.
    The overall clinical results, as judged by relief of pain, walking ability, improvement of hallux valgus and claw toe deformities, plantar callosities, selection of shoes and the patients' own assessment, were satisfactory (good or excellent) in all feet.
    The X - rays at the time of follow -up showed that the hallux valgus angle was significantly improved in all feet. The first and second (fifth) intermetatarsal angles showed no significant difference postoperatively.
    The measurement of the relative metatarsal protrusion (Hardy, 1951), defined as the difference between the length of the first and second metatarsals, showed the importance of adequate resection of the metatarsal heads. When the first metatarsal was left longer than the second after surgery, a recurrence of hallux valgus deformity tended to occur. Our experience suggests that a space of 1.5 cm between the resected metatarsal and the proximal phalanx is necessary to prevent new callosity formation and claw toe deformity.
  • Michito TAKAGI
    1986 年 5 巻 3 号 p. 385-390
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    In the first half of the period from 1975 to 1985 we treated patients with hallux valgus by Hammond's operation, which is a modified Mitchell's operation, and in the latter half by modified chevron osteotomy. Chevron osteotomy, as described by J.R. Corless, is a method in which a V-shaped osteotomy is done with the apex of the V towards the first metatarsophalangeal joint in the saggital plane and the head is slid laterally. In modified chevron osteotomy, as described by J.L. Randall, the contact area of the osteotomy plane is increased and stabilized by the extension of both arms of the V.
    Tewnty-five feet were operated on in 17 patients, all female, with arangeof age from 23 to 63 years old (average: 46) . Two of these patients had rheumatoid arthritis and one cerebral palsy. The average duration time of symptoms before operation was 26 months. Six patients were treated with Hammond's operation and 11 with modified chevron osteotomy, with average operation times of 71 minutes and 42 minutes respectively. The time until full weight-bearing was 8 to 12 weeks with the former method and 4 to 6 weeks with the latter.
    The average follow-up time was 7 months. Radiologically the intermetatarsal angle was corrected from 16±2° (M±SD) to 11±4° by Hammond's operation and from 13±3° to 11±3 ° by modified chevron osteotomy. Tenderness and pain in walking disappeared or decreased in all of the former cases and in 80% of the latter. Based on the superiority of the operative procedure and length of postoperative care, we concluded that modified chevron osteotomy was a good operation for mild or moderate cases of hallux valgus.
  • 並木 脩, 藤巻 悦夫, 力丸 暘
    1986 年 5 巻 3 号 p. 391-398
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    The results and problems with 34 knees in 23 cases of Okayama Mark II total knee replacement (TKR), and 16 cases of 23 Bioceram KOM type TKR were investigated.
    Needless to say, one of the most important factors in operative results is surgical technique. Almost the same satisfactory results were obtained with both cementless (ceramic) TKR and cemented TKR.
    Better results could be expected by setting a more adequate osteotomy angle. It is clear that instruments, design of prosthesis and principle of surgical techniques should be improved to accomplish this. One example would be cutting the tibia in a slightly posteriorly tilted angle.
    In the Okayama Mark II TKR, good results could not always be obtained even in cases with good alignment, even those in which TKR was set in the posteriorly shifted position, and more accurate technique is required.
    In contrast, satisfactory results were obtained in a wide range of alignments with the Bioceram TKR. However there was a case in which a structural defect was observed.
    It was also shown that cementless TKR has an advantage with respect to salvaging; that is, fairly good knee function could be maintained after removal of the prosthesis.
  • 龍 順之助, 小林 茂夫, 中村 和久, 鳥山 貞宜
    1986 年 5 巻 3 号 p. 399-407
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    For the purpose of obtaining the most ideal and precise placement in future total knee prostheses, we evaluated the position of the devices used in such operations at our hospital by our own radiological scoring system. In a follow-up period of three years and nine months on 71 joint operations in 51 cases evaluated through radiography, 41 received scores of excellent (51%) ; 19, good (27%) ; 9, fair (12%) ; and 2, poor (3%) . The early clinical results of total knee arthroplasty were compared with these.
    The results showed that there were tendencies for cases with good clinical results to have good radiological scores and, to the contrary, for cases with poor results not to.
    In this short term study there was no significant positive correlation between good clinical results and a well-positioned prosthesis. But it seemed suggested that long-term clinical results would definitely be correlated with the positioning of the prosthesis.
    The comparison of the total condylar type and the kinematic type of total knee replacement showed that the kinematic type was better than the total condylar type in both clinical and radiological scores.
  • 内藤 二郎, 三枝 康宏, 大野 修, 廣畑 和志
    1986 年 5 巻 3 号 p. 409-412
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    A sixteen-year-old male had symptoms referable to the posterior lateral compartment of the knee, specifically the region of the fabella. The features included intermittent pain in the posterolateral region accentuated by knee extension, localized tenderness over the fabella and no restriction of range of knee motion. The symptoms and signs of peroneal nerve palsy were not observed. The arthroscopic findings showed no articular hyaline cartilage face on the fabella and no inflammatory changes of the synovia. Partial resection of the fabella was done. The patient had complete relief of symptoms following surgery. The etiology of the pain may have been related to friction between the gastrocnemius tendon and the fascia.
  • 水野 芳隆, 村上 恒二, 平林 徹, 安達 長夫, 生田 義和
    1986 年 5 巻 3 号 p. 413-418
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    We extirpated a large popliteal cyst in an RA-complicated rare case of intestinal lymphangiectasia which is a representative disease among protein losing gastroenteropathies.
    The patient was a 57-year-old female whose chief complaint was a painful tumor formation in the left leg. She had begun to suffer from swelling and pain in both hands in 1971 that was diagnosed as RA. Edema of both legs developed in 1979, and subsequent swelling of the abdominal region was diagnosed as intestinal lymphangiectasia. Moreover, a cyst formed in the back of the left hand in 1981 and was relieved by curettage. Swelling and pain on the posterior surface of the left leg occurred in 1982. It did not decrease with puncture treatment, and she was admitted to our hospital in October, 1983. At that time ulner deviation of fingers on both hands, Swanneck deformity, and deformities of anterior feet, and also swelling of the left leg and restriction of the ROM of the left knee joint were noted. Test findings showed serum total protein had decreased remarkably to 3.3g/dl, and a round cystic pattern with a major axis of 25cm was noted in the posterior surface of the left leg by arthorography of the left knee. IVH was conducted for 1 month, and the operation was postponed until the serum total protein had raised to 4.4g/dl. After extirpation of the large cyst on the posterior surface of the left leg, an operation was performed which included left knee joint synovectomy. At present, 2 years later, no recurrence of pain has been noted, and a normal gait has become possible.
    This case is thought to be an extremely rare one of complicated intestinal lymphangiectasia due to RA, and hypoproteinemia due to the intestinal lymphangiectasia is assumed to be responsible for the formation of the large cyst.
  • 岡野 良文, 加藤 義治, 山田 均
    1986 年 5 巻 3 号 p. 419-424_1
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    The five-year follow up on a 5-year-old girl with infantile Blount disease with an epiphyseal separation of the distal femur was reported on. The results were not successful. The local pathology in this case is discussed including the epiphyseal abnormality of the distal femur.
    The causes of unsatisfactory results can be mechanical derangement due to extreme varus deformity of the knee and tibia plateau deformity as well as localized epiphyseal disturbance in the distal femur.
  • 三枝 康宏, 大野 修, 広畑 和志, 石川 斉, 内藤 二郎, 塚西 茂昭
    1986 年 5 巻 3 号 p. 425-429
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Pathological glenohumeral joint dislocation due to long-standing rheumatoid synovitis in a 75 years old patient is described. Operative findings showed a large defect in the posterolateral portion of the humeral head and complete destruction of the labrum. The cause of shoulder dislocation in the wake of rheumatoid inflammation is discussed.
  • 西田 淳, 阿部 正隆, 山崎 忠保, 佐藤 孝
    1986 年 5 巻 3 号 p. 431-436
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    Sea urchin injury in rare cases can produce tuberculoidgranuloma.The MP joint region of the volar side of the right thumb of a 53-year-old fisherwoman was penetrated by a sea urchin spine in September, 1981. On the following day local heat and swelling occurred in the volar side of the right hand. She was treated as having phlegmon and tenosynivitis for 2 months; thereafter the symptoms decreased, even though she was not cured. Three years later she came to our hospital because of pain, swelling and stiffness of the right thumb. Active ROM of the IP joint of the thumb was 5-10 degrees.
    X-rays showed oval hyperlucent lesions approximately 5mm in diameter in the head of the proximal phalanx and base of the distal phalanx. The cortex was destroyed. After 6 months curettage was performed and the ROM was improved to 0-25 degrees afterwords. Microscopic examination of the tissue obtained by curettage showed tuberculoid granuloma with caseous necrosis. Ziel-Neelsen's stain demonstrated acid-fast bacilli which we think were mycobacterium marinum.
  • 渡辺 真, 柳沢 正信, 松本 淳
    1986 年 5 巻 3 号 p. 437-443
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    An increased incidence of malignant lymphoma has been suggested to occur in various auto-immune diseases. Rheumatoid arthritis (RA) is the commonest of these diseases, but the risk of malignancy in RA is very rare. However we encountered a case of RA which showed an intimate relationship with malignant lymphoma.
    This case was a man who had suffered from RA since 15 years old. He had continuously been given various kinds of drugs including steroids and gold, but not within the previous 10 years. At age of 40, a tumor was discovered on the left elbow and he received two excisions for it. The diagnosis of malignant lymphoma was confirmed after the second excision. The laboratory examinations showed a positive CRP-test, negative RA-test, normal immunoglobulins-IgA 271mg/dl, IgG 1255 and IgM 116 - and so on. He was given anti-cancer chemotherapy (ADM and 5-Fu) and irradiation (Co-60) after the excision. At the present time, he is 46 years old and there has been no evidence of recurrence or metastasis.
  • 田窪 伸夫, 渡部 昌平, 石丸 公平, 西本 裕俊, 白岡 格, 柴田 大法, 野島 元雄, 内海 爽, 加納 誠, 山本 純己, 八野田 ...
    1986 年 5 巻 3 号 p. 445-450
    発行日: 1986/12/20
    公開日: 2010/10/07
    ジャーナル フリー
    The antibody against the proteoglycan antigen of human articular cartilage was measured by the enzyme-linked immunosorbent technique in sera from 33 patients with rheumatoid arthritis, 12 patients with osteoarthritis and 43 normal donors. High titers of an anti- proteoglycan antibody were encountered frequently in sera of rheumatoid arthritis patients as well as of those with osteoarthritis. In patients with rheumatoid arthritis, however, no relation could be established between the titer of the anti-proteoglycan antibody and disease features such as duration of disease, stage, laboratory tests or rheumatoid serology. The titer was found to be in parallel with that of anti-collagen type II. The results suggest that the production of anti-proteoglycan antibody is not responsible for the pathogenesis of rheumatoid arthritis but is presumably a consequence of the inflammatory and degenerative process in joints.
  • 1986 年 5 巻 3 号 p. e1a
    発行日: 1986年
    公開日: 2010/10/07
    ジャーナル フリー
  • 1986 年 5 巻 3 号 p. e1b
    発行日: 1986年
    公開日: 2010/10/07
    ジャーナル フリー
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