http://hdl.handle.net/10564/1537 2000-04 2026-04-10T15:42:04Z http://hdl.handle.net/10564/596 タイトル: 急性膵炎の経過中に肝梗塞を合併した1例 著者: 山本, 広光; 久我, 由紀子; 西浦, 公章; 花谷, 正和; 上村, 史朗; 山野, 繁; 橋本, 俊雄; 土肥, 和紘 抄録: We report a rare case of acute pancreatitis with hepatic infarction. A 71- year-old woman was admitted to our hospital because of sudden upper abdominal pain and severe nausea. Physical examination revealed upper abdominal tenderness with mild muscle defense, and hepatomegaly. Blood examination revealed high levels of serum amylase and lipase. Abdominal echography showed swelling of the entire pancreas and bright lever. The patient was diagnosed as having acute pancreatitis. Abdominal CT scan on admission showed swelling of the pancreas and bilateral fluid collection behind the kidneys without liver abnormalities. The patient was treated with continuous intravenous drip injection of gabexate mesilate(30 mg/kg)and ulinastatin(150,000 IU)daily. On the 6th hospital day, serum amylase and lipase levels and liver dysfunction were normalized, and the patient's, subjective symptoms were diminished. However, on the 16th hospital day, she had right hypochondralgia, high grade fever, and mild liver dysfunction. A contrast- enhanced abdominal CT scan showed a small, wedge-shaped, low-attenuation area in the right lobe of the liver. Hepatic infarction was diagnosed. Although the patient was not treated because the infarction was small, she recovered quickly. 2000-04-29T15:00:00Z http://hdl.handle.net/10564/595 タイトル: 住居用酸性洗剤の飲用で胃前庭部短軸方向に線状潰瘍を発症した1例 著者: 山路, 國弘; 後, 一肇; 川野, 貴弘; 西岡, 久之; 久我, 由紀子; 丸山, 直樹; 団野, 大介; 京田, 有輔; 中川, 陽子; 西浦, 公章; 藤本, 眞一 抄録: A case of corrosive linear gastric ulcer on the antrum developing in the short axial direction caused by ingestion of domestic acidic detergent is reported. The patient was a 49-year-old woman without any psychiatric diseases, but had been suffering from a depressive state since her father died in June of 1998. On June 19, 1999, she was admitted to Oyodo Municipal Hospital as an emergency because she had ingested about 50 ml of a domestic acidic detergent with the intention to commit suicide. Gastrointestinal fiberscopy(GIF)on admission revealed severe erosions in the entire stomach but few abnormal findings in the esophagus. We initiated fasting therapy and intravenous high calory infusion therapy, and began to inject antibiotics and H2 blockers. GIF on the 11th day after admission showed severe redness from the lower part to the antrum of the stomach and a long linear ulcer on the short axis direction of the greater curve on the antrum, but no abnormal findings in the esophagus and the duodenum. GIF on the 18th day after admission indicated improvement in the long linear ulcer on the antrum, and the patient was discharged on July 13. 2000-04-29T15:00:00Z http://hdl.handle.net/10564/594 タイトル: 水腎症を契機に発見された膀胱瘤の1例 著者: 山口, 旭; 山本, 雅司; 松村, 善昭; 川上, 隆; 藤本, 清秀; 大園, 誠一郎; 平尾, 佳彦; 寺西, 明子; 春田, 祥治; 森川, 肇 抄録: A case of cystocele complicated with bilateral hydronephrosis is reported. A 70-year-old woman was referred to our hospital for further examination for bilateral hydronephrosis in April, 1999. Clinical and radiological examinations revealed grade 3 cystocele. She underwent transvaginal hysterectomy and anterior & posterior colporrha- phy ; thereafter hydronephrosis disappeared. The pathogenesis and management of this rare condition are discussed. 2000-04-29T15:00:00Z http://hdl.handle.net/10564/593 タイトル: 陳旧性心筋梗塞例での冠予備能による心筋 viability の評価 著者: 井上, 文隆 抄録: We investigated the usefulness of the coronary flow reserve(CFR)for estimation of myocardial viability in patients with old myocardial infarction(MI). Twenty-three patients with old anterior MI, who had single vessel disease of the left anterior descending artery(LAD), enrolled in this study. They had undergone transluminal angioplasty and had no restenosis of the target lesioon on the follow-up coronary angiogra- phy. CFR was measured with a Doppler guidewire during the follow-up angiography in the LAD. Based on the CFR, these patients were divided into two groups : those who showed more than 2.0(Group H), and those who showed less than 2.0(Group L). The myocardial scintigraphy using thallium-201(Tl)and iodine-123-β-methyl-p-iodophenyl pentadecanoic acid(BMIPP)were examined 7±2 months after the MI onset. Based on the regional Tl and BMIPP uptake, the severity score(SS)was defined. The Tl/BMIPP discrepancies between SS on the early phase BMIPP and the delayed phase of Tl were studied. The former was higher than the latter. The SS of Tl and BMIPP, and the frequency of Tl/BMIPP discrepancies were compared between the two groups. The relationships between CFR and the SS were also studied. In Group H, both the SS of Tl and the SS of BMIPP were lower(Tl : P＜0.001 ; BMIPP : P＜0.001)than those in Group L. The frequency of the Tl/BMIPP discrepancy was higher(P＜0.001)than that in Group L. The relationship between CFR and the SS of Tl showed a statistically negative correlati on (early : r=0.64, p＜0.01 ; delayed : r=0.62,p ＜0.01). The relationship between CFR and the SS of BMIPP showed a statistically negative correlation(early : r=0.58, p＜0.01 ; delayed : r=0.52, p＜0.05), as well. The area of myocardium showing Tl/BMIPP discrepancy is viable. We concluded that CFR of infarct related coronary artery can reflect the regional Tl and BMIPP uptake and is useful for the estimation of myocardial viability in patients with old myocardial infarction. 2000-04-29T15:00:00Z