The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
38 巻, 4 号
選択された号の論文の7件中1~7を表示しています
  • 土屋 雅春, 朝倉 均, 吉松 博
    1989 年 38 巻 4 号 p. 383-402
    発行日: 1989年
    公開日: 2009/03/27
    ジャーナル フリー
    Autoimmune diseases such as ulcerative colitis (UC) and myasthenia gravis (MG) are frequently associated with thymic abnormalities. Thymus hyperplasia and/or thymoma have been demonstrated in all cases with both of these two diseases by pneumomediastinography (PMG). In the diseases of digestive organs from which we can easily obtain the local information through the endoscopic observation and biopsy specimens, lots of immunological abnormalities have been accumulated. Antibody-dependent cell-mediated cytotoxicity mechanism has been demonstrated to play an important role in the mucosal destruction in UC. In the peripheral blood level of this disease, immunological abnormalities have been demonstrated such as the presence of lymphocytes sensitized by certain antigens, autoantibodies and disturbances of lymphocyte subpopulations. In the level of the thymus, the retrovirus has been detected in the thymus epithelial cells. The supernatant of thymus epithelial cell culture (STEC) has the capability of differentiating human bone marrow cells and of facilitating disease-specific immune abnormalities. Moreover, the serum factors (thymus growth factor) discovered in the patients with UC and MG, have been demonstrated to alter the thymic environments. Therefore, it is postulated that thymectomy is beneficial to exclude these abnormalities and it has been evaluated to be very effective in UC and MG clinically. From these observations, it is thought to be important to investigate the immunological abnormalities of autoimmune diseases from the viewpoints of three immunological levels, the level of disease-specific organ, the peripheral blood level and the level of the thymus. And it is important that the therapeutic plans should be decided in the consideration of the abnormalities in each immunological level.
  • 丸田 俊彦
    1989 年 38 巻 4 号 p. 403-412
    発行日: 1989年
    公開日: 2009/03/27
    ジャーナル フリー
    Of 98 consecutive patients admitted to a pain management program for patients with nonmalignant chronic pain, 34 were definitely depressed, 20 were probably depressed, and 44 were not depressed by research diagnostic criteria (RDC). At the time of admission, no characteristic differences were observed among the three study groups except for, by definition, the presence of a RDC diagnosis of major depression (definite or probable) and an associated increase in Hamilton depression scale score and a group of MMPI scale scores. There was a 98% improvement rate for depression by participation of the patients in a nonpharmacologic program for nonmalignant chronic pain; there were no differences in frequency of depression among the three study groups at the time of dismissal. This progress was maintained at long-term follow-up (average, 11.6 months): 87 of 98 patients (88.8%) remained nondepressed.
  • 辻 浩司, 福田 宏之, 川崎 順久, 川井田 政弘, 神崎 仁
    1989 年 38 巻 4 号 p. 413-418
    発行日: 1989年
    公開日: 2009/03/27
    ジャーナル フリー
    It is commonly accepted that radiotherapy is a first choice for treatment of T1 glottic cancer. However, side effects caused by irradiation are sometimes troublesome to a patient and to a physician. Among side effects, oncogenic problem and late radiation change are most undesirable and may become fatal. Hence, we avoid radiation therapy especially for younger aged patients. We prefer surgical therapy to radiotherapy for such a case. In our clinic, laser therapy has been employed. A laser beam is introduced through an operation microscope and a lesion can be microscopically vaporized. In this study, a survey of 40 patients with T1 glottic cancer submitted to laser surgery was reviewed. From those patients 25 were T1a and 15 were T1b. From our experience, laser vaporization is recomendable for T1 glottic cancer in younger aged patients. However, in order to obtain cure rate comparable to radiation therapy, the indication must be correctly designated.
  • 美原 盤
    1989 年 38 巻 4 号 p. 419-431
    発行日: 1989年
    公開日: 2009/03/27
    ジャーナル フリー
    Abnormalities in the central cholinergic system have been reported in Alzheimer disease. The present study was designed to evaluate the effects of the central cholinergic neurons in the substantia innominata on cognitive functions and cerebral metabolism in rats. Forty-nine Wistar rats were trained for an active avoidance task for 5 days. On Day 5, rats which had acquired the avoidance response were divided into two groups. The lesioned group (n=7) received ibotenic acid in the substantia innominata bilaterally and the sham-operated group (n=7) received the vehicle only. From Day 8 to 12, the rats were again trained for the avoidance task. On Day 12, the local cerebral metabolic rate for glucose was measured by the 14C-2-deoxyglucose method. The rats in the lesioned group revealed severe deficits in retention and re-acquisition of the active avoidance task. In addition, the glucose metabolism was decreased in the cerebral cortices, especially in the frontal cortex (p<0.05). The central cholinergic neurons of the substantia innominata may be closely related to cognitive functions and to glucose metabolism in the cortices.
  • 佐藤 敏彦, 東 敏昭, 桜井 治彦, 大前 和幸
    1989 年 38 巻 4 号 p. 432-442
    発行日: 1989年
    公開日: 2009/03/27
    ジャーナル フリー
    Exposure evaluation is an essential facet in the assessment of the risks of exposure to toxic materials in the workplace. Presently, samples from the breathing atmosphere are measured in order to determine the level of individual exposure to toxic substances. This method, however, does not take into account the level of physical exertion during exposure. Physical activity is known to increase pulmonary ventilation by up to 10 times that of the level at rest. Thus, measurement of pulmonary ventilation, as well as the concentration of a toxic material in the air would provide valuable data in evaluating exposure. We have developed a device that measures and records the concentration of a toxic material in the air and pulmonary ventilation as predicted by heart rate both simultaneously and continuously. In this system, real time pulmonary ventilation is predicted from heart rate by using a regression equation that was obtained from the results of our study. The percentage error of predicted pulmonary ventilation at each heart rate is within 30%. The present study assessed the feasibility of the use of heart rate as the predictor of pulmonary ventilation. Our new exposure monitoring system is the first practical device that monitors the level of exposure dependent upon pulmonary ventilation and will be useful in the revaluation of threshold limit values (TLV's) and in working management.
  • Jing-juan Ding, 斎藤 英胤, 森實 敏夫, 加川 建弘, 松本 信吾, 岩渕 直人, 土屋 雅春, 渡辺 哲, 熊谷 直樹, ...
    1989 年 38 巻 4 号 p. 443-453
    発行日: 1989年
    公開日: 2009/03/27
    ジャーナル フリー
    Hepatitis B virus (HBV) DNA integration was studied in 24 hepatocellular carcinoma (HCC) tissues obtained at operations or autopsies. In 11 cases whose sera were positive for hepatitis B virus surface antigen (HBsAg), HBV DNA integration was demonstrated by Southern blot analysis. Only one of 6 cases whose sera were positive for hepatitis B surface antibody (HBsAb) but negative for HBsAg revealed the integration and the other 5 cases revealed no HBV DNA integration. HBV DNA amplification was noted in 4 of these 6 cases in which HBV DNA integration was found when compared with the adjacent liver tissues. The integration pattern of HBV DNA was different in one case between primary HCC tissue and a metastasized lymph node. It is suggested that HBV DNA amplification is not directly related to the development of HCC and that there are polyclonal tumor cells which have different patterns of virus genome integrations.
  • 甲田 英一, 茂松 直之
    1989 年 38 巻 4 号 p. 454-463
    発行日: 1989年
    公開日: 2009/03/27
    ジャーナル フリー
    In order to achieve practical application for the treatment planning of radiotherapy, lung density was assessed by means of CT. Cork phantoms were measured 360 times to test the reliability of CT densitometry. Densities were corrected by the CT value of pure water measured at the same time. The mean value of cork phantoms as measured by CT was 0.287±0.11g/cm3, the true value of which was 0.320g/cm3. These errors were within an allowable limit for radiotherapy. Lung density was studied in 50 patients with a mean age of 50 years, ranging from 46 to 76. The values obtained of the upper, middle, and lower lung were 0.123±0.46 g/cm3, 0.121±0.033, and 0.154±0.057 g/cm3 during inspiration and were 0.215±0.058 g/cm3, 0.228±0.066, and 0.260±0.078g/cm3 during expiration, respectively. The dorsal, central, and ventral portions of the lung were measured simultaneously with a patient on supine position. In order to hold the variation of radiation dose within 2%, the variation must be kept within 30 HU of CT value. As for the upper lung, the difference of which between both subjects and sites was smallest during inspiration in this results, that was 20%; the difference of 60 HU CT value existed between the dorsal and ventral lungs. Variations in CT number between subjects were more than 60 HU in one third of this series. Before starting radiotherapy to the lung field, lung densitometry is warranted in order to irradiate the exact dose.
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