東京女子医科大学雑誌
Online ISSN : 2432-6178
Print ISSN : 0040-9022
ISSN-L : 0040-9022
87 巻, 6 号
選択された号の論文の6件中1~6を表示しています
目次
総説 循環系の基礎と臨床
  • 小川 哲也
    2017 年 87 巻 6 号 p. 151-159
    発行日: 2017/12/25
    公開日: 2017/12/25
    ジャーナル フリー

    Arteriosclerosis is usually classified into atherosclerosis and arteriosclerosis. Nephrosclerosis and renal artery stenosis are important regarding arteriosclerosis in the kidney. Nephrosclerosis advances because of hypertension and aging. Glomerulosclerosis includes two types of abnormalities that are complete opposites, namely ischemia-related sclerosing lesions and sclerosing lesions with glomerular hypertension. Furthermore, it is therapeutically important to decide which of these is the primary pathological condition. Moreover, 90 % of renal artery stenosis cases are atherosclerotic. Activation of the renin-angiotensin-aldosterone system by hypoperfusion of the stenotic kidneys causes renal contraction and renal fibrosis in the long term. Renal artery stenosis worsens the prognosis because of the occurrence of cardiovascular events.

    Arteriosclerosis in chronic kidney disease (CKD) is a promoting/aggravating factor of CKD itself. The progression of arterial wall sclerosis of the aorta is a characteristic finding of CKD. For diagnosing arteriosclerosis, it is common to perform carotid ultrasonography, imaging diagnostic modalities such as computed tomography/magnetic resonance imaging, structure evaluation of the vessels, and vascular function testing of the cardio-ankle vascular index, pulse-wave velocity, and ankle-brachial index. Recently, the relationship between intestinal bacteria and arteriosclerosis has garnered attention. Trimethylamine N-oxide (TMAO) in blood has been reported to promote arteriosclerosis, and TMAO is produced by the metabolism of trimethylamine in the liver, which is a degradation product of dietary choline by intestinal bacteria.

総説
  • 大森 安恵
    2017 年 87 巻 6 号 p. 160-164
    発行日: 2017/12/25
    公開日: 2017/12/25
    ジャーナル フリー

    This paper is based on a special lecture in the 12th annual meeting of The Laughter and Health Association in October, 2017. In 2016, one of my co-workers, Dr. Shun Ito reported about the mechanism of lowered blood glucose, the decline due to laughter.

    As diabetes continues to increase, which studies point out as national disease, I thought that this year's theme ought to be "Clinical treatment of Diabetes as seen through Senryu" in accordance with the fundamental spirit of the Laughter and Health Association.

    As I think this theme will contribute not only to ordinary People, but also to medical doctors in training for diabetes or for beginner medical doctors, I decided to write this report. Senryu have been made by diabetic patients in Ebina General Hospital・Diabetes Center and diabetic problems are mixed.

    The definition of diabetes, the history of diabetes, the treatment of diabetes, diabeticcomplication, specially dementia etc. have been recorded.

  • 西山 圭子, 小森 万希子, 立石 実, 松本 卓子, 冨澤 康子
    2017 年 87 巻 6 号 p. 165-169
    発行日: 2017/12/25
    公開日: 2017/12/25
    ジャーナル フリー

    Medical doctors actively participate in academic meetings and study intensively to achieve self-improvement in medical science and practice and thereby develop possibilities for future career success. It is important and valuable experience to learn techniques for questions and answers and discussions at academic meetings and to interact with people at social gatherings, along with reading academic books and journals. Participation or making academic presentations at academic societies is indispensable to becoming a specialist. Establishment of daycare nursery centers in academic meetings has been proposed as one of the positive actions to improve the environment to enable female doctors to continue to work actively. Here, we present information useful for the organizers of academic meetings at the time of setting up daycare nursery centers. The use of daycare centers differs depending on the academic society and is affected by factors such as whether the number of uses is small or conversely waiting for cancellation; the cost burden also varies. We find good examples of safety management, including cooperation with neighboring doctors. As the number of female doctors and the demand for academic daycare centers will increase, each academic society must secure nursery teachers, a place, and a budget to establish daycare nursery centers.

報告
  • 浅野 千尋, 児玉 聖子, 磯野 紀子, 鬼澤 俊輔, 廣島 健三, 増田 道彦
    2017 年 87 巻 6 号 p. 170-173
    発行日: 2017/12/25
    公開日: 2017/12/25
    ジャーナル フリー

    Spontaneous splenic rupture in lymphoproliferative disease is very rare. Herein, we report a case involving a 50-year-old man diagnosed with mantle cell lymphoma-blastoid variant who experienced spontaneous splenic rupture. The patient underwent splenectomy and recovered without incident. At first histological examination of the spleen suspected chronic lymphocytic leukemia. About one month after splenectomy multiple lymphadenopathy developed. A lymph node biopsy resulted mantle cell lymphoma-blastoid variant. He received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), hyper-CVAD/MA chemotherapy (hyper-fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone alternating with methotrexate and cytarabine), and ICE therapy (ifosfamide, carboplatin, and etoposide). However despite intensive chemotherapies, the disease became refractory, and the patient died 5 months after initiating chemotherapy. We discuss a case of high-grade lymphoproliferative disease with spontaneous splenic rupture treated with splenectomy and chemotherapy.

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