The Kurume Medical Journal
Online ISSN : 1881-2090
Print ISSN : 0023-5679
ISSN-L : 0023-5679
Volume 49, Issue 3
Displaying 1-12 of 12 articles from this issue
  • YASUMI ARAKI, YUICHIRO SATO, KOICHIRO KIDO, SHOJIRO TORIGOE, YUKIYA KI ...
    2002 Volume 49 Issue 3 Pages 81-85
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    Rectosigmoidal obstruction due to a malignant tumor usually requires emergency surgical treatment, and colostomy is usually inevitable. This report describes our experience with the use of endoluminal self-expanding metallic stents in the treatment for rectosigmoidal obstruction in patients with unresectable recurrent colorectal cancer or intra-abdominal dissemination. A total of 5 cases were included (4 male and 1 female) with a mean age of 70.8 (range, 63-80) years. A selfexpanding noncovered Ultraflex, 10 cm in length and 22 mm in diameter, was emplaced at the site of the obstruction under both endoscopic and fluoroscopic guidance. Each patient had a recurrent malignancy (colorectal cancer, 3; ovarian cancer, l ; gastric cancer, 1). No subsequent surgery was planned due to ascites or extensive intra-abdominal dissemination. There was no mortality related to the procedure. Immediate decompression with symptomatic relief was achieved. One stent later became obstructed due to tumor ingrowth, and in two cases there was intermittent bleeding from the tumor and these were treated by argon plasma coagulation (APC) endoscopically. The use of self-expanding Ultraflex stent provides good palliation for unresectable advanced tumors that cause left colonic obstruction.
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  • RYO NOGUCHI, HIDEO ANDO
    2002 Volume 49 Issue 3 Pages 87-89
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    The aim of the experiments was to observe whether or not there is an immune system reaction to vibration stress. Three vibration frequencies were randomly given to 6 male volunteers. The 63 Hz vibration frequency produced a significant decrease in the ratio of CD4 T-cell to CD8 Tcell. This finding suggests that acute vibration stress suppresses the immune system activity in humans body.
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  • YU MONDEN
    2002 Volume 49 Issue 3 Pages 91-97
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    To evaluate the cataract surgery with intraocular lens (IOL) implantation in patients with uveitis, we retrospectively compared the outcome and complications between 63 eyes with uveitisassociated cataract and 42 eyes with age-related cataract, and between 27 uveitis eyes implanted with acrylic IOL and 36 uveitis eyes implanted with heparin-surface-modified IOL. There was a significant difference in the incidence of postoperative complications between patients with uveitis and age-related cataract. Major postoperative complications in uveitis group were posterior capsule opacification (13%) and cystoid macular edema (13%). Flare intensity measured with the laser flare-cell meter in patients with uveitis was higher than that with age-related cataract. There was no significant difference in the incidence of the postoperative complications and flare intensity between eyes with acrylic IOL and with heparin-surface-modified IOL in uveitis group, but there was a significant difference in the intensity of astigmatism in short-term after the surgery between the two groups. Careful attention to preoperative activity of uveitis and postoperative complications should be paid in cataract surgery with IOL implantation in patients with uveitis. Acrylic IOL is as useful as heparin-surface-modified IOL.
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  • YOSHIRO EGUCHI, MICHIRO INOUE, SHIZUKA IIDA, KEI MATSUOKA, SHINSHI NOD ...
    2002 Volume 49 Issue 3 Pages 99-107
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    We reported that expression of both HSPG and of bikunin are increased in calcium oxalate (CaOx) nephrolithic rat kidneys (lida et al., J. Am. Soc. Nephrol. 1999, Urol. Res.1997). However, these findings were obtained from separate experiments. The present study evaluates whether levels of HSPG and bikunin expression differ in the rat kidney during calcium oxalate nephrolithiasis. Twenty-four male Wistar rats weighing 200-250 g were assigned to one of four groups (n=6 each group) and administered with 0.5% ethylene glycol daily and 0.5 μg of 1 α-OH-D3 every other day to induce CaOx nephrolithiasis. Animals were sacrificed 1 or 2 weeks later and both kidneys were excised. The cortex was separated from the medulla and papillary tips in the right kidney, then stored in liquid nitrogen for quantitative competitive-reverse transcription-polymerase chain reaction (QC-RT-PCR). The left kidney was fixed in 10% buffered formalin for histochemical studies. We assessed the variable gene expression of both HSPG and bikunin by QC-RT-PCR. Immunohistochemical analyses of left kidney tissue samples determined the localization of HSPG and bikunin. Normal rats serving as controls (n=6 each) were also sacrificed and processed in the same manner as the experimental groups. QC-RT-PCR confirmed that HSPG and bikunin mRNA expression is significantly increased in nephrolithic kidneys (p<0.05; Mann-Whitney test), and that medulla and papillary tips tended to express more mRNA of both. Immunohistochemical studies revealed that the production of HS and bikunin was increased in both the distal and proximal tubules of nephrolithic kidneys. These findings suggest that the increased expression of both HSPG and bikunin play an important role during calcium oxalate stone formation. In addition, this phenomenon might be associated with the progression of urothelial damage.
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  • AKIRA SHIBATA, MICHIYO MATSUO, KATSUHIRO FUKUDA
    2002 Volume 49 Issue 3 Pages 109-117
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    A comparison of responses obtained in interviews using a structured questionnaire and those obtained using a self-administered questionnaire about parental history of liver diseases and personal smoking and drinking habits was made to evaluate whether the self-administered questionnaire is an effective means for collecting information on these variables in place of an interview. The subjects used in the present analyses were 46 male hepatocellular carcinoma (HOC) cases and 46 hospital controls who were interviewed between January, 1996 and January, 1997 for HOC cases and between January, 1996 and April, 1997 for hospital controls. Ages at start or stop of smoking and drinking were grouped into four categories as categorical variables. The cumulative number of cigarettes and cumulative alcohol consumption were also grouped into four categories. Generally speaking, the degree of agreement was substantially high for both categorical and continuous variables, particularly for parental history of liver diseases, and smoking (ICC=0.929 and 0.912 for cases and controls, respectively) and drinking (ICC=0.899 and 0.882, respectively) habits that are originally nominal categorical variables. On the other hand, the cumulative number of cigarettes (ICC=0.928 and 0.716, respectively) and the cumulative alcohol consumption (ICC=0.761 and 0.825, respectively) seemed to have a lower degree of agreement than other variables. For these variables, there was a tendency for the self-administered questionnaire to produce larger values compared with the interview. Therefore, the self-administered questionnaire seemed to be an effective means for collecting information on categorical variables, while the interview using a structured questionnaire seemed to be preferable to the self-administered questionnaire with regard to the lifetime exposure to cigarettes and alcohol.
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  • AKIRA AKASHI, KOICHI KUWANO
    2002 Volume 49 Issue 3 Pages 119-129
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    Interleukin-2 (IL-2) plays an important role as an immunoregulatory mediator. It is also known to enhance the killing activity of killer cells such as natural killer (NK) cells or lymphokineactivated killer (LAK) cells. When cytotoxic T lymphocytes (CTL) lyse antigen (Ag)-treated target cells, the presence of IL-2 enhances the killing activity of CTL. In the present study, we examined the mechanisms by which IL-2 treated CTL lyse normal target cells at the cellular and mRNA levels. Our results suggest that IL-2 treated CTL can lyse target cells predominantly via Fas-mediated mechanism and to a lesser extent via a granule exocytosis-based mechanism. Interestingly, the level of FasL mRNA in CTL clone remained unchanged following IL-2 treatment, whereas the level of expression of Fas ligand (Fast) on CTL surface was slightly enhanced. On the other hand, treatment with metalloproteinase inhibitor augmented the level of FasL expression on the cell surface of CTL as well as the activity of target cell killing. Our results indicate that IL-2 plays a crucial role in the regulatory mechanisms of target cell killing by CTL without TCR-stimulation.
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  • KAZUKO NISHIDA, EMIKO WATANABE, RIKA KINJO, MASAKI SHINJO, EIKI NISHID ...
    2002 Volume 49 Issue 3 Pages 131-142
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    The purpose of this study is to identify factors contributing to tooth retention. A questionnaire was prepared which includes 22 main items concerning oral health care. The questionnaire was answered by 144 females in their 80's at 4 Health and Welfare Centers for the Aged in the City of Naha in July 1995 through interview format. Data were analyzed using multiple logistic regression, in which the dependent variable was tooth retention. The results were as follows: 1) The mean number of teeth of those in their 80's was 3.8±7.2; 2) A high percentage, 122 (84.7%), were observed to be in moderate or excellent health; 3) Less than half, 63 (43.7%), were observed to have a strong family history of oral health; 4) Character (p<0.01), those having a periodical oral health checkup from their 50's (p<0.01) and total oral health care in their 50's (p<0.05) were statistically significant. The results also suggest that the multiple logistic regression model consisted of character (odds ratio (OR)=11.62); having a periodical oral health checkup from their 50's (OR=9.39); and total oral health care in their 50's (OR=4.23) among elderly females in their 80's in Okinawa Prefecture.
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  • SHOKO SHIMOKAWA, TAKASHI HAYASHI
    2002 Volume 49 Issue 3 Pages 143-147
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    In the past 20 years, 43 patients with congenital hydrocephalus underwent surgical treatment for hydrocephalus in our clinic (Myelomeningocele, Dandy-Walker syndrome, holoprosencephaly and hydranencephaly, which are frequently associated with dysgenesis of the corpus callosum, were excluded). The gestational stage at the onset of hydrocephalus was assessed on the basis of the morphology of the corpus callosum. The patients were then divided into four groups according to stage of onset. A relation between the stage of onset and the long-term functional scores was demonstrated. The earlier the gestational stage at which the hydrocephalus occurred, the lower was the long-term functional score.
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  • YASUMI ARAKI, YUKIYA KISHIMOTO, YUICHIRO SATO, SHOJIRO TORIGOE, KOICHI ...
    2002 Volume 49 Issue 3 Pages 149-151
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    When a simple procedure such as bougie, balloon dilation and transanal incision are not effective for severe stenosis after colorectal anastomotic leakage, a surgical operation is required. We report a case of transanal dilation using circular stapling for severe stricture in the colorectal anastomosis following low anterior resection.
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  • KEISHIRO AOYAGI, KIKUO KOUFUJI, SHOJIRO YANO, NAOTAKA MURAKAMI, MOTOSH ...
    2002 Volume 49 Issue 3 Pages 153-156
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    We have experienced a case of early gastric carcinoma associated with amyloidosis. The patient was a 63-year-old woman diagnosed as having early gastric cancer type 0 ha at the anterior wall on the greater curvature of the antrum, and multiple polypoid lesions on the antrum to the body of the stomach. We performed total gastrectomy, and ρ-Roux-en-Y reconstruction. The tumor lesion was recognized at the anterior wall of the prepylorus, and the multiple polypoid lesions which were composed of anyloid masses were recognized on the whole stomach. The histological findings of the biopsy specimens from the rectum and the skin showed no amyloid-deposit. The urine examination was negative for a Bence-Jones protein reaction. This was a rare case of early gastric carcinoma associated with stomach amyloidosis, apparently confined to the stomach.
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  • KEISHIRO AOYAGI, KIKUO KOUFUJI, SHOJIRO YANG, NAOTAKA MURAKAMI, MOTOSH ...
    2002 Volume 49 Issue 3 Pages 157-160
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    We have experienced a case of long-term survival after treatment with low dosage 5-fluorouracil (5-FU) and Cisplatin (FP regimen). The patient was a 60-year-old man diagnosed as having advanced gastric cancer type 3 with numerous large lymph node metastases. After treatment with 2 courses of FP regimen, the primary tumor and para-aortic lymph nodes were decreased in size by 41 % and 92%, respectively, and the serum level of alpha-fetoprotein was decreased to normal. We then recommended surgery, but the patient did not consent. Therefore, he was treated with a third course of FP regimen. He died at 3 years later. These results suggested that the FP regimen was an effective treatment for advanced gastric cancer which was difficult for curative resection because of the numerous large lymph node metastases.
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  • HISAFUMI KINOSHITA, MITSUO HASHIMOTO, KAZUNORI NISHIMURA, TAKAHITO KOD ...
    2002 Volume 49 Issue 3 Pages 161-165
    Published: September 17, 2002
    Released on J-STAGE: August 11, 2009
    JOURNAL FREE ACCESS
    We report 2 patients with acute cholecystitis for which percutaneous transhepatic gallbladder aspiration (PTGBA) was useful. In Case 1, the patient was a 75-year-old woman who experienced a sudden onset of back pain and upper abdominal pain at night. Abdominal ultrasound (US) showed enlargement of the gallbladder with thickening of the wall, a sonolucent layer, and a stone in the neck of the gallbladder, which led to a diagnosis of acute cholecystitis. Magnetic resonance imaging (MRI) demonstrated thickening of the gallbladder wall and 2 areas of low-intensity signal. The pain and fever persisted, for which we performed PTGBA, aspirating about 113 ml of infected bile. Subsequently, the pain and fever subsided, and abdominal US revealed a reduction in the enlargement of the gallbladder with the persistence of thickening of the wall. On the eighth day after PTGBA, open abdominal cholecystectomy was performed. In Case 2, the patient was a 56-year-old woman who had right hypochondriac pain after supper. The pain gradually increased in severity. Abdominal US showed enlargement of the gallbladder with a thickened wall, a sonolucent layer, and a gallstone in the neck of the gallbladder, which led to a diagnosis of acute cholecystitis. Magnetic resonance cholangiopancreatography (MRCP) showed enlargement of the gallbladder with no abnormalities in the common bile duct. After admission to hospital, the pain and fever persisted, for which we performed PTGBA, aspirating about 50 ml of infected bile. Subsequently, the pain and fever vanished. Abdominal US revealed a reduction in the enlargement of the gallbladder with the persistence of thickening of the wall. On the seventh day after PTGBA, laparoscopic cholecystectomy was performed. PTGBA seems useful for early alleviation of the symptoms of acute cholecystitis because of low invasiveness and ease of performance.
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