Journal of The Showa Medical Association
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
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Volume 70, Issue 6
Displaying 1-9 of 9 articles from this issue
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Feature Articles: Epidemiological Approaches to Health Problems in Childhood
Original
  • PARTICIPATION OF INTESTINAL DOPAMINE RECEPTOR IN CONSTIPATION OF PARKINSON'S DISEASE MODEL RAT
    Hiroto TANIGAWA, Masataka SUNAGAWA, Satoshi SAKAUE, Yu SAITO, Shi-yu G ...
    2010 Volume 70 Issue 6 Pages 472-479
    Published: December 28, 2010
    Released on J-STAGE: June 30, 2011
    DOIhttps://doi.org/10.14930/jsma.70.472
    JOURNAL FREE ACCESS
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    Parkinson's disease PD a progressive neurodegenerative disorder characterized by extrapyramidal symptoms, is often associated with non-motor symptoms. Constipation appears most frequently in the non-motor symptoms, and it is generally considered to be caused by autonomic disturbance. On the other hand, changes of enteric dopaminergic systems are also reported. It was reported that dopamine inhibits the intestine motility, and from among dopamine receptors, dopamine receptor D2 D2R in particular participates. The role of D2R in the constipation of PD is not clear. Therefore, the present study was conducted to clarify the mechanism of constipation in PD, especially the participation of D2R using the PD model rat. PD model rat was established by unilateral injection of 6-hydroxydopamine 6-OHDA into the medial forebrain bundle. Rats were bred in the metabolic cage and the amount of feces was measured for 28 days. The amount of feces of PD rats was significantly less than that of control rats. Thereafter, PD rat's colon was removed and the motility was recorded in Krebs solution. When apomorphine, that is the dopamine receptor agonist, was added to the Krebs solution, the movement was significantly inhibited compared with that of control rats. Moreover, D2R and tyrosine-hydroxylase TH were examined using immunohistofluorescent methods. The number of D2Rs in the colon was significantly increased in the PD group. There was no significant difference in TH-positive neurons dopaminergic neurons. These results suggested that the intestinal tract, at least in the colon, of the PD rat became more sensitive to dopamine due to the increase of the number of D2Rs, and had an influence in the movement of the intestinal tract.
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Case Reports
  • A RARE CASE OF MILIARY TUBERCULOSIS DEVELOPING TO ACUTE RESPIRATORY DISTRESS SYNDROME IN WHICH THE PATIENTS LIFE WAS SAVED
    Genyo OGAWA, Takashi KATSURA, Norihiro NOMURA, Masashi SATOH, Ryouji H ...
    2010 Volume 70 Issue 6 Pages 480-487
    Published: December 28, 2010
    Released on J-STAGE: June 30, 2011
    DOIhttps://doi.org/10.14930/jsma.70.480
    JOURNAL FREE ACCESS
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    The patient was an 84-year-old male who was treated for hypertension in another hospital. In addition to general malaise and anorexia lasting for about a month, the patient had a high fever, which prompted the referral to our department. Chest x-ray and chest CT scan upon admission revealed ground glass appearance and diffuse granular infiltration in both lung fields. We suspected a pulmonary infection, such as miliary tuberculosis, and an anti-TB regimen and ciprofloxacin CPFX were administered. Mycobacterium tuberculosis in the sputum, gastric juices, and urine were detected several days later by bacteriological tests, confirmed the diagnosis of miliary tuberculosis. On the third day of hospitalization, hypoxemia worsened and developed into acute respiratory distress syndrome ARDS; the patient was immediately placed on a ventilator and corticosteroids were administered. The patient responded well to these treatments, and was successfully extubated 6 days later. The patient had slow but steady, uneventful recovery after extubation, and he was discharged home on hospital day 83. Review of literature indicates an extremely poor prognosis of miliary tuberculosis developing to ARDS, with mortality of 70-80. We believe that this patient survived due the to early introduction of anti-TB drug therapy, even before the diagnosis was confirmed. When an elderly individual develops a high fever of unknown origin with pulmonary infiltrate, a differential diagnosis must be made with miliary tuberculosis in mind and anti-TB drug therapy should be initiated even before the diagnosis is confirmed.
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  • A CASE OF LUNG METASTASIS OF LEFT FLANK MALIGNANT MELANOMA
    Daisuke KATAOKA, Yuri TOMITA, Motoko FUKAYAMA, Mitsutaka KADOKURA, Mas ...
    2010 Volume 70 Issue 6 Pages 488-493
    Published: December 28, 2010
    Released on J-STAGE: June 30, 2011
    DOIhttps://doi.org/10.14930/jsma.70.488
    JOURNAL FREE ACCESS
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    A 54-year-old man felt a mass on the left axilla three years previously. Because some malignant melanomas metastasized to the left axillary lymph node, we thoroughly examined him from head to foot to identify the primary tumor.
    We found the primary tumor in the left flank and performed resection and cancer chemotherapy. We found a 10mm tumor in the middle lobe of the right lung, one year and six months after the surgery of the primary tumor. It was suspected that the tumor was a metastasis of the malignant melanoma to the lung, and that surgery was necessary, but he refused it. However, because of tumor enlargement, he accepted right middle lobectomy. It was 11 months after his abnormal chest shadow was pointed out. The tumor was an oncogenic lesion of 33mm including the border; the sectioned surface was white. For tissue pathologic findings, we diagnosed the metastases to the lung of the amelanotic melanoma. The postoperative course is good and he has been followed up in the outpatient department for 18 months postoperatively. It is thought that there are few cases with surgical indication for this disorder, however if surgical complete resection is possible, then prognosis improvement is expected, and therefore it is important to examine the presence of positive surgical indication.
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