http://hdl.handle.net/10564/1536 2000-02 2026-04-10T15:42:04Z http://hdl.handle.net/10564/588 タイトル: 腹部造影CTとカラードプラエコーが診断に有用であった腎梗塞の2例 著者: 那須, 賢哉; 林, 照剛; 勝山, 慶之; 酢谷, 俊夫; 中野, 智幸; 平井, 純; 川本, 篤彦; 土肥, 和紘 抄録: We report two cases of renal infarction. Case 1 involved a 49-year-old man wht complained of left back pain. Case 2 involved a 50-year-old woman who had suffered from hypertension for ten years and had experienced a myocardial infarction 5 years previously and a cerebral infarction 4 years before her admission with right flank pain. In both cases, contrast-enhaneed CT scan and color Doppler ultrasound demonstrated a hypoperfused area of the kidney, and both patients were diagnosed with renal infarction. Urokinase and heparin were administered intravenously in both cases. In case 1, contrast -enhanced CT scan and color Doppler ultrasound performed one week after admission revealed improved arterial blood flow in the infarct area. In case 2, the same tests performed after one week demonstrated no improvement in renal arterial blood flow. In conclusion, contrast-enhanced CT scan and color Doppler ultrasound are useful in distinguishing renal infarction from other forms of acute abdomen. 2000-02-28T15:00:00Z http://hdl.handle.net/10564/587 タイトル: CAPDに合併した胸水貯留に対して自己血注入による胸膜癒着術が有効であった1例 著者: 川野, 貴弘; 京田, 有輔; 団野, 大介; 中川, 陽子; 山路, 國弘; 丸山, 直樹; 久我, 由紀子; 西岡, 久之; 後一, 肇; 西浦, 公章 抄録: We report a case of hydrothorax in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD) who was treated with autologous blood pleurodesis. A 46-year-old woman with end-stage renal failure due to IgA nephropathy started CAPD on February 9, 1994. After 19 days, she was admitted to our hospital because of dyspnea. A chest X-ray revealed right pleural effusion. Pleuroperitoneal communication was diagnosed because the glucose concentration in the pleural fluid was high compared with that in her blood. Autologous blood pleurodesis was performed after drainage of the pleural effusion. After 4 weeks, CAPD was restarted, and hydrothorax did not recur. Autologous blood pleurodesis may be useful in the treatment of hydrothorax in a patient receiving CAPD. 2000-02-28T15:00:00Z http://hdl.handle.net/10564/586 タイトル: 通過静脈皮弁移植の実験的研究とその臨床応用 著者: 平井, 利幸; 福居, 顕宏; 玉井, 進; 稲田, 有史 抄録: In recent years, conventional flaps which make a sacrifice of main arteries as reported frequently in the early stage of their development have been reevaluated in the field of flap surgery. This movement has facilitated development of flaps vascularized by perforating branches measuring about 0.3 mm in diareter, and has also thrown light on the merits of venous flaps which make no sacrifice of main arteries. Looking back on the history of venous flaps, they initially attracted attention because, in contrast to conven- tional flaps, 1) they do not make a sacrifice of main arteries, 2) they are not limited by the conditions of the recipient site, and 3) preparation of the flap is technically easy and applicable to emergency operations. Because of these advantages, venous flaps have been used widely in the clinical setting, but the mechasism of flap survival remains conjectural. The present study was designed to determine the limits of venous flap viability supplied by one vein, which is one of the questions related to venous flap stirvival. A flom-through venous flap measuring 3.0×3.0 cm was prepared in the lateral margin of the auricle in rabbits, and the area of flap viability was determined. The influences of surrounding blood circulation on the area of flap viability were also investigated. As a result the width of flap covered by one vein was 11.0±4.8 mm as a whole, whereas it was 18.1±6.2 mm in the presence of good blood circulation in the surroundings, showing a significant effect of surrounding blood circulation. Based on these experimental data, flow-through venous flaps were applied to 25 patients and the stability of the flaps was confirmed. The presence of arteriolar systems in perivenous tissues has been demonstrated recently. To provide the venous flap with blood flow from the arteriolar system is another way to improve the viability of venous flaps. 2000-02-28T15:00:00Z http://hdl.handle.net/10564/585 タイトル: ヒト型結核菌に対するマウス系統間における抵抗性及び肺病変の比較 著者: 油納, 善久 抄録: Five inbred strains of mice were examined for resistance to intravenous infection with 10^5 colony-forming units of Mycobacterium tuberculosis H37Rv. Based on the difference in survival time, five strains were classified into two groups : susceptible (CBA and DBA/2) and resistant (BALB/c, A/J, C57BL/6) strains. After infection with M. tuberculosis, mycobacteria rapidly multiplied in the lung with low levels of pulmonary IL- 12 production in CBA mice ; resulting in the progression of necrotic pneumonia. In contrast, mycobacteria slowly multiplied in association with high levels of IL-12 production in the lung of C57BL/6 mice ; leading to the development of granulomas. In C57BL/6 mice, the growth of bacteria was suppressed over a long period (6th-24th weeks) after infection, and granulomatous response in the lung was followed by progressive fibrosis capable of prevent- ing bacterial dissemination. When alveolar macrophages from both strains were infected in vitro with M. tuberculosis at a ratio of 1 : 10, the degree of phagocytic activity was not different between two strains, but C57BL/6 cells displayed higher anti-mycobacterial activity compared to CBA cells. These results suggest that murine natural resistance against M. tuberculosis depends on the anti-mycobacterial activity of alveolar macrophages, and the early production of IL-12 in the lung upon infection appears to be associated with the innate resistance and subsequent induction of M. tuberculosis-specific immunity. Moreover, vaccination with BCG was effective in reducing bacterial growth in both mouse strains during the initial phase of infection, while its effect was expressed in only resistant mice as the retardation of histopathologic progression during the late phase. 2000-02-28T15:00:00Z