2005-04 http://hdl.handle.net/10564/1570 2026-04-10T15:42:25Z 2026-04-10T15:42:25Z 玉本, 哲郎 吉村, 均 浅川, 勇雄 藤本, 正男 福井, 博 家根, 旦有 高, 済峯 松尾, 祥弘 城根, 憲 http://hdl.handle.net/10564/132 2017-05-29T06:07:05Z 2005-04-29T15:00:00Z

タイトル: 化学放射線療法後に原発腫瘍とリンパ節転移に石灰化をきたした頚部食道癌の1例 著者: 玉本, 哲郎; 吉村, 均; 浅川, 勇雄; 藤本, 正男; 福井, 博; 家根, 旦有; 高, 済峯; 松尾, 祥弘; 城根, 憲 抄録: A 68-year-old woman with neck swelling and dysphagia presented at our hospital in February of 2002. In CT findings, a tumor invading the trachea and cervical lymph node metastasis (LN met) were found. No distant metastasis was observed. Therefore, we diagnosed cervical esophageal cancer (T4N3MO: stage IVa) clinically, and performed chemoradiotherapy concurrently. Radiotherapy was performed by a 4 MV linear accelerator, at a total dose of 60 Gy with a fraction of 2 Gy per day. Chemotherapy was administered as 2 cycles of cisplatin (CDDP) at 6 mg/m^2/day and 5-fluorouracil (5-Fu) at 300 mg/m^2/day (day 1-5, 8-12). After these treatments, the tumors reduced markedly and calcifications could be detected in the esophageal tumor and LN mets in CT. However, a few months later, mediastinal LN met was found, so we again performed chemoradiotherapy. Radiotherapy was performed by a 10 MV linear accelerator, at a total dose of 30 Gy with a fraction of 2 Gy per day. Chemotherapy was administered as 1 cycle of CDDP at 10 mg/day and 5～Fu at 500 mg/day (day 1-5, 8-12). After this treatment, additional chemotherapy was administered as 1 cycle of nedaplatin at 10 mg/day and 5-Fu at 500 mg/day (day 1-5, 8-12). About 10 months after the first treatment, the primary tumor grew again and the dysphagia worsened. Finally, the patient died of hemorrage due to the local tumor. We report here a rare case of calcification in presumed esophageal cancer after radiotherapy. This case suggests that the tumor calcification is a marked tumor response after chemoradiotherapy.

2005-04-29T15:00:00Z Nishikubo, Toshiya Kisato, Yoriko Ishikawa, Naoko Kuwahara, Isao Kamitsuji, Hidekazu Yoshizato, Kazuaki Araki, Eiichi http://hdl.handle.net/10564/131 2017-05-29T06:07:15Z 2005-04-29T15:00:00Z

タイトル: NEPHROGENIC DIABETES INSIPIDUS WITH A V2 RECEPTOR MUTATION AT A FUNCTIONALLY CRITICAL SITE 著者: Nishikubo, Toshiya; Kisato, Yoriko; Ishikawa, Naoko; Kuwahara, Isao; Kamitsuji, Hidekazu; Yoshizato, Kazuaki; Araki, Eiichi 抄録: We present an infant with congenital nephrogenic diabetes insipidus with a V2 receptor mutation. The infant was admitted to our hospital because of high fever 7 days after birth. Laboratory examinations demonstrated elevated serum sodium (152 mEq/L) and chloride (113mEq/L) concentrations. Plasma osmolarity was increased to 312 mOsm/kg, even though urinary osmolarity was 76 mOsm/kg. Serum AVP concentration was markedly increased. Pitressin-loading test did not show marked increment in the urinary osmolarity or secretion of urinary cyclic-AMP. Therefore, the patient was clinically diagnosed as having nephrogenic diabetes insipidus. DNA analysis of the V2 receptor gene identified a C to A transition at nucleotide position 1503. This mutation leads to a predictable change from Proline to Histidine. The patient was fed a sodium-restricted formula and administered trichlormethiazide. After initiating treatment, the serum concentration of Na was maintained below 150 mEq/L, and there was no physical dysfunction or mental retardation. Early diagnosis followed by early interventions was important to improve the prognosis.

2005-04-29T15:00:00Z 木内, 邦明 森川, 将行 洪, 基朝 池下, 克実 飯田, 順三 大澤, 弘吉 猪原, 淳 法山, 良信 平山, 智英 根來, 秀樹 扇谷, 嘉成 徳山, 明広 金, 英浩 五十嵐, 潤 根本, 隆哉 高橋, 弘幸 中田, 正樹 林, 竜也 横山, 敬輝 橋本, 和典 岸本, 年史 http://hdl.handle.net/10564/130 2017-05-29T06:07:05Z 2005-04-29T15:00:00Z

タイトル: 奈良県立医科大学附属病院精神科における2000年度の新入院・外来患者臨床統計 著者: 木内, 邦明; 森川, 将行; 洪, 基朝; 池下, 克実; 飯田, 順三; 大澤, 弘吉; 猪原, 淳; 法山, 良信; 平山, 智英; 根來, 秀樹; 扇谷, 嘉成; 徳山, 明広; 金, 英浩; 五十嵐, 潤; 根本, 隆哉; 高橋, 弘幸; 中田, 正樹; 林, 竜也; 横山, 敬輝; 橋本, 和典; 岸本, 年史 抄録: Nosological data on outpatients and inpatients in the Psychiatric Service of Nara Medical University Hospital in fiscal 2000, are reported in this paper. The total of outpatients were 928 cases and inpatients were 219 cases. According to the diagnostic classification using F codes of the ICD-10, F4 (neurotic, stress-related and somatoform disorder) were most frequent (247 cases, 26.6%) of the outpatients, followed by F3 (mood disorder ; 218 cases, 23.5%), F2 (schizophrenia schizotypal and delusional disorder ; 121cases, 13%) and others. On the other hand , F3 (mood disorder) were most frequent ( 68cases, 31.1% ) of the inpatients, followed by F2 (schizophrenia schizotypal and delusional disorder; 55 cases, 25.1%), F4 (neurotic, stress-related and somatoform disorder; 40 cases, 18.3%) and others.

2005-04-29T15:00:00Z 森田, 孝夫 http://hdl.handle.net/10564/129 2017-05-29T06:07:15Z 2005-04-29T15:00:00Z

タイトル: 医学教育論　教育原理,成人教育学,専門家(プロフェショナル)教育理論より医学教育を考える 著者: 森田, 孝夫 抄録: 日本の医学教育は従来,時間制で全科目必修であったが,現在は原則単校訓で科目の改変再編が顕著に進み,基礎・社会・臨床医学のみならず教養科目との統合(インテグレーション)が進行している。また,新しい教育原理や成人教育学理論に基づいて,教授方法も講義から少人数チュートリアルなどによる問題基盤型学習(PBL-tutorial)へ,また,プロフェショナル教育理論に基づいて,臨床実習も見学型から診療参加型のクリニカル・クラークシップヘと移行しつつある。また,個々の大学の多様性を盛り込んだ特色あるカリキュラムの採用が進んでいる。このような変革の時代にあって,改革の方向を正しく見据えて対処するためには,教育改革の根底にある教育理論を理解することが重要と考えられる。現在進行している教育改革を教育原理,成人教育学,専門家教育論などの教育理論から概説する。

2005-04-29T15:00:00Z