日本医科大学医学会雑誌
Online ISSN : 1880-2877
Print ISSN : 1349-8975
ISSN-L : 1349-8975
7 巻 , 4 号
選択された号の論文の23件中1~23を表示しています
橘桜だより
グラビア
シリーズ カラーアトラス
綜説
  • 高橋 謙治
    2011 年 7 巻 4 号 p. 150-155
    発行日: 2011年
    公開日: 2011/12/22
    ジャーナル フリー
    Osteoarthritis (OA) is a frequent musculoskeletal disorder in the elderly population. OA is characterized by a gradual loss of extracellular matrix in the articular cartilage of joints. No medical agents have shown evidence that they are disease-modifying OA drugs, which attenuates progression of OA, nor has practical application of biological agents that are intended to alleviate symptoms been realized. Therefore, it is preferable to administer conservative therapy that is easy, simple, and effective in inhibiting OA progression at an early stage. Heat shock protein 70 (HSP70) has a protective effect on the cartilage and inhibits the apoptosis of chondrocytes. Hyperthermia to the joints can increase HSP70 expression in chondrocytes, and, at the same time, HSP70 expression partially enhances matrix metabolism of the cartilage. These findings suggest that hyperthermia can be applied to the treatment of OA. Hyperthermia is, therefore, expected to be an inexpensive and less-invasive conservative therapy for OA.
論説
原著
  • 古川 清憲, 下條 悦子, 大田 久子, 岡野 雄三, 佐藤 正巳, 高橋 浩
    2011 年 7 巻 4 号 p. 162-165
    発行日: 2011年
    公開日: 2011/12/22
    ジャーナル フリー
    Gathering information in the forms of complaints from patients, reports from staff, and surveys conducted by the hospital is an essential element in providing safe, high-quality medical care. We have analyzed the contents of letters placed to the opinion box in 1 year from January 1, 2010, and examined them from the viewpoint of the quality of medical care. In total, 121 letters with 127 opinions were posted. Overall, 74.4% of the letters were anonymous. The largest percentage of opinions (44.9%; 57 of 127 opinions) were about the behaviors and attitudes of the hospital staff towards patients, followed by requests to the hospital (15%; 19 opinions) , opinions about hospital facilities (12.6%; 16 opinions) , and complaints about waiting time and other issues (9.4%; 12 opinions) . Overall, 83.5% of all comments were complaints. From the viewpoint of the quality of medical care, 27.6% of the comments were about "structure," 66.9% were about "process," and 3.1% were about "results." A large part of the structural problems can be improved with the launch of the new hospital. The remaining structural problems and process problems might be addressed by conducting cross-sectional restructuring and by upgrading the organization of the existing hospital, thus improving both the patients' satisfaction rate and the quality of medical care. Letters in the opinion box should be regularly reviewed (Plan-Do-Check-Action Cycle) in the future to maintain and improve the quality of medical care.
医学教育トピックス
基礎研究から学ぶ
症例から学ぶ
  • 須田 智, 大久保 誠二, 阿部 新, 金丸 拓也, 斉藤 智成, 神谷 信雄, 酒巻 雅典, 三品 雅洋, 上田 雅之, 桂 研一郎, 片 ...
    2011 年 7 巻 4 号 p. 175-178
    発行日: 2011年
    公開日: 2011/12/22
    ジャーナル フリー
    Vertigo and nausea suddenly developed in a 33-year-old man without a relevant medical history. He reported that he had had throbbing headaches for 1 month. On admission, neurological examination revealed dysarthria, right Horner syndrome, and hypoesthesia of the left side of the face and of the left side of the body below the neck. Initial magnetic resonance imaging of the brain showed no areas of abnormal intensity on diffusion-weighted imaging, but magnetic resonance angiography showed a stringlike structure of the right vertebral artery. Acute infarction due to right vertebral artery dissection was diagnosed. Heparin sodium was immediately administered intravenously. Three days after symptom onset, magnetic resonance imaging-diffusion-weighted imaging of the brain clearly showed a high-intensity area in the right lateral medulla oblongata, a finding that confirmed the clinical diagnosis. This case emphasizes that vertebral artery dissection should be considered in patients with vertigo, especially young patients without risk factors for cerebrovascular disorders. The clinical history and neurological examination remain fundamental aspects of patient assessment in the era of advanced neuroimaging.
症例報告
  • 阿部 正徳, 渡辺 誠, 山内 仁紫, 落 雅美, 小川 俊一
    2011 年 7 巻 4 号 p. 179-182
    発行日: 2011年
    公開日: 2011/12/22
    ジャーナル フリー
    A 19-year-old man was admitted to our hospital for elective surgery to replace the ascending aorta. The patient's father had died suddenly of aortic dissection associated with Marfan syndrome. Because of the patient's family history and physical findings, we suspected Marfan syndrome and began regular observations of aortic size when he was an infant. When he was 18 years old, magnetic resonance cardiography showed a marked increase in the size of the ascending aorta, replacement of which was indicated. Computed tomography performed before the planned elective surgery incidentally revealed dissection of the ascending aorta, although the patient was asymptomatic. Thus, we failed to prevent the aortic dissection in this patient, although we had regularly observed the aorta since he was an infant. Surgery should have been performed earlier than it was. Our experience suggests more frequent observation and stricter indications for aortic surgery should be considered in Marfan syndrome.
話題
JNMSのページ
集会記事
第79回日本医科大学医学会総会抄録
feedback
Top