信州医学雑誌
Online ISSN : 1884-6580
Print ISSN : 0037-3826
ISSN-L : 0037-3826
65 巻, 1 号
選択された号の論文の15件中1~15を表示しています
巻頭言
最終講義抄録
綜説
原著
  • 岩出 珠幾, 高見澤 滋, 好沢 克
    2017 年 65 巻 1 号 p. 31-35
    発行日: 2017/02/10
    公開日: 2017/03/01
    ジャーナル フリー

    Purpose : Evaluation of the drainage of perianal abscesses at first visit by a retrospective study of the treatment of perianal abscess in infants.
    Methods : The study included 15 infants who were treated for perianal abscess between April 2008 and April 2015. We divided the sample into two groups based on whether or not the abscess was drained at their first visit. The group without drainage included six patients who were treated with the herbal medicine Juzen-taiho-to without drainage. The drainage group included nine patients who were treated with Juzen-taiho-to with drainage. The age of onset/visit, body weight at the time of visit, dose of Juzen-taiho-to, number of hospital visits, duration of treatment, and recurrence rate were compared between the two groups.
    Results : There were no differences in the age of onset/visit, body weight at the time of visit, dose of Juzen-taiho-to, number of hospital visits, and duration of treatment between the two groups. The recurrence rate in the group without drainage was higher than that in the drainage group (33% vs 0%, p<0.05).
    Conclusions : Our results support the drainage of perianal abscesses in infants at their first visit to reduce the risk of recurrence.

  • Masakuni ISHIKAWA, Tetsuya IMAMURA, Osamu NISHIZAWA, Osamu ISHIZUKA
    2017 年 65 巻 1 号 p. 37-44
    発行日: 2017/02/10
    公開日: 2017/03/01
    ジャーナル フリー

    Purpose : Erectile dysfunction (ED) decreases the quality of life. However, some patients are refractory to phosphodiesterase-5 (PDE-5) inhibitors. This preliminary study investigated the possibility that autologous bone marrow-derived cells could improve the ED of spontaneously hypertensive rats (SHRs).
    Materials and Methods : Erectile responses were induced by apomorphine. Bone marrow cells were harvested from femurs of SHRs, and following culturing and labeling, they were implanted autologously into the corpus cavernosum penis. Control SHRs received cell-free injections. At 7 days after the implantation, apomorphine-induced erectile responses were estimated. The presence of implanted bone marrow-derived cells in the corpora cavernosa and the expression of neuronal nitric oxide synthase (nNOS) were determined by microscopy and reverse transcription polymerase chain reaction.
    Results : The number of the negative reactions for apomorphine in the SHRs was significantly higher compared to the Wister Kyoto (WKY) rats (P=0.045). Ten of 15 cell-free control SHRs did not respond to apomorphine, while 8 of 9 cell-implanted SHRs responded. Significantly more cell-implanted SHRs responded to apomorphine than did cell-free SHRs (P<0.013). The implanted cells formed clusters within the corpora cavernosa, and some expressed nNOS mRNA and protein.
    Conclusions : Bone marrow-derived cells autologously implanted into the corpus cavernosum penis significantly increased the number of SHRs having erectile responses to apomorphine.

症例
  • 小池 綏男, 平賀 理佐子, 高木 哲
    2017 年 65 巻 1 号 p. 45-49
    発行日: 2017/02/10
    公開日: 2017/03/01
    ジャーナル フリー

    A relatively rare case of neuroendocrine tumor of the breast was reported.
    A 67-year-old female visited the out-patient clinic at our hospital complaining of bloody discharge flowing from the nipple of her right breast in March 2010.
    The bloody discharge flowed from her right nipple when a trigger point on the D-region of her right breast was pressed.
    Several supplemental diagnostic examinations were performed, but the exact diagnosis could not be confirmed and her clinical course was therefore followed.
    After 11 months from the first medical examination a 3cm diameter tumor in the D-area of the right breast was palpable.
    The tomor was suspected to be breast cancer by the findings of mammary ductography and fine needle aspiration biopsy cytology.
    Ultrasound-guided core needle biopsy was then performed to obtain the exact diagnosis and breast cancer was able to be diagnosed.
    A neuroendocrine tumor was suspected on the basis of immunohistochemical examinations.
    A right modified radical mastectomy and axillary lymph node dissection were performed.
    Histopathologically,most of the tumor consisted of noninvasive ductal carcinoma that had partially invaded surrounding fatty tissues.
    Tumor cells showed clear, eosinophilic cytoplasm and contained oval or spherical nuclei with fine granulated chromatin and were formed into a pseudorosette arrangement.
    Nucleal atypia of the tumor cells was grade 1. The tumor was clearly diagnosed as a neuroendocrine tumor because the majority of tumor cells were stained strongly positive by immunochemical staining (Chromogranin A and Synaptophysin).
    The tumor showed neither vessel invasion nor signs of axillary lymph node involvement.
    Immunohistochemically, estrogen receptor and progesterone receptor were positive and human epidermal growth factor receptor 2 was negative.
    Based on the above findings, the patient was administerd aromatase inhibitor (anastrozole) for five years. and remains well without any signs of recurrence as of May 2016.

  • Shuhei NOZAWA, Masanori YASUO, Hiroshi YAMAMOTO, Mineyuki HAMA, Kazuna ...
    2017 年 65 巻 1 号 p. 51-56
    発行日: 2017/02/10
    公開日: 2017/03/01
    ジャーナル フリー

    A 72-year-old female with systemic lymphadenopathy was diagnosed with multicentric Castleman's disease (MCD), following a needle biopsy of her axillary lymph node. She experienced recurrent fever and a rash, and was then transferred to our respiratory department. She had fever and dyspnea with consolidation and pleural effusion on computed tomography (CT). Lung lesions are common but pleural effusion is an unusual symptom in Castleman's disease. We administered antibacterial agents but her condition worsened. Symptoms rapidly improved following administration of systemic corticosteroid, and the consolidation and pleural effusion also disappeared. We suggest that pleural effusion in Castleman's disease should be considered as a differential diagnosis for pleural effusion that is unresponsive to antibacterial treatment.

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