http://hdl.handle.net/10564/1549 2008-08 2026-04-09T03:41:45Z http://hdl.handle.net/10564/579 タイトル: INDUCTION OF SMALL BOWEL TRANSPLANTATION TOLERANCE BY DONOR-SPECIFIC BONE MARROW TRANSPLANTATION 著者: Ko, Saiho; Kanokogi, Hideki; Kanehiro, Hiromichi; Okayama, Junji; Okano, EiJi; Nakajima, Yoshiyuki 抄録: Immune response after allogeneic small bowel transplantation is more vigorous compared to other organ transplantations. It is often difficult to control small bowel allograft rejection with conventional immunosuppressive therapy. While many experimental studies showed organ transplantation tolerance, there have been few reports of tolerance in allogeneic small bowel transplantation. Induction of bone marrow chimerism is a potent strategy of tolerance induction. We tried to induce tolerance in SBT using donor-specific bone marrow transplantation (BMT) with cyclophosphamide (CYP) and tacrolimus. BN and LEW rats were used as donors and recipients. LEW recipients received BMT from BN donors after injection of CYP. The recipients were further treated with 0.3 mg/kg/day tacrolimus on days 0-6 (n=5). Establishment of bone marrow chimerism in BMT recipients was evaluated by flowcytometry of peripheral blood mononuclear cells. These recipients received small bowel transplantation from BN donors on day 100 after BMT. All of these recipients accepted BN small bowel allografts indefinitely (＞100 days), while untreated LEW controls rejected BN grafts within 8 days (n=6). Histologic signs of chronic rejection were not observed in small bowel allografts in these recipients. In conclusion, donor-specific BMT with a single dose of CYP and a short course of tacrolimus in the early phase successfully induced small bowel transplant tolerance across MHC-barriers. This strategy may lead to technical innovation of immuno- suppressive treatment in clinical small bowel transplantation. 2008-08-30T15:00:00Z http://hdl.handle.net/10564/578 タイトル: 荷重時背底X線像における母趾基節骨回内評価法の考案 著者: 阪本, 達哉; 田中, 康仁; 秋山, 晃一; 片岡, 弘行; 河口, 泰之; 高倉, 義典; 東野, 義之 抄録: The purpose of this study was to establish a new method for quantifying the amount of hallucal rotation on weight-bearing dorsoplantar radiographs and to explore the relationships between hallucal rotation and hallux valgus deformity. Methods: Anatomical features that enable assessment of the first proximal phalanx rotation were identified at the medial tubercle of its proximal articular surface. A Rotation Index (A/B x 100% : RI) was defined as the distance between the tip of the medial tubercle and the long axis (A), and the distance between the most medial and lateral edges of the proximal articular surface (B). The data were analyzed using a single regression analysis to investigate the relation between the value of the RI and the first proximal phalanx rotation (PRA). Using this single regression equation, the value of PRA was calculated from the RI on each dorsoplantar radiograph. Measurements were made of 78 feet of 48 female patients with symptomatic hallux valgus. As a control, 58 normal feet of 46 female subjects were also examined. A Pearson correlation coefficient was used to evaluate the relationship between the PRA and the hallux valgus angle (HVA). Results: A trend of decreasing RI with increasing pronation was observed, and the relationship was approximately linear. At a pronation of 10 degrees, an average change in the magnitude of the RI of 6.06% was observed. The mean value of the first proximal phalanx rotation angle was 8.5°in the control group and 27.7°in the hallux valgus group. We found that there was a high correlation between the amount of the first proximal phalanx rotation angle and the hallux valgus angle. The regression coefficient was 0.68. Conclusions: We conclude that the RI is reliable and usefu1 for accurately assessing the hallucal rotation under the weightbearing condition 2008-08-30T15:00:00Z http://hdl.handle.net/10564/577 タイトル: THE PREVALANCE OF HYPEROPIA AMONG PEOPLE WITH 20/20 UNCORRECTED VISUAL ACUITY 著者: Mine, Masashi; Nawa, Yosmaki; Hara, Yoshiaki 抄録: Purpose: To investigate the proportion of hyperopia among people with 20/20 uncorrected visual acuity Methods: We prospectively evaluated the percentage of hyperopia in 113 consecutive eyes of 70 patients with 20/20 uncorrected visual acuity and no ocular diseases. The mean (±standard deviation) age of the group was 55±11 (ranging 15 to 88) years old. The spherical equivalent of the subject refraction was used for the analysis. Results: The percentage of hyperopia (≧＋0.25D) in the population was 53%. Conclusions: To our knowledge, this is the first report that investigated the percentage of hyperopia in a group of people with 20/20 uncorrected visual acuity. We should recognize that eyes with 20/20 uncorrected visual acuity comprise a substantial proportion of hyperopia. 2008-08-30T15:00:00Z http://hdl.handle.net/10564/576 タイトル: 不定愁訴患者に対する当院総合診療医の対応 著者: 團野, 大介; 藤本, 眞一; 中村, 忍 抄録: There are many patients presenting at the outpatient clinic of General Medicine with non-specific complaints. It is reported that non-specific complaints are sometimes indicative of undiagnosed depressive illness. We investigated our assessment of the patients who presented with non-specific complaints in our outpatient clinic of General Medicine. Methods : We retrospectively investigated 23 patients (6 males and 17 females, aged 19-75 years; median age, 32 years) who presented at our department for an evaluation of non-specific complaints between December 2002 and November 2005. We initially reviewed the patient's medical records, and then investigated the patient's current status by means of a telephone interview. Results : In order to make diagnosis of physical disorder, 14 cases were investigated by screening examinations, including laboratory studies, chest X-rays, and physical examinations. In 9 cases, a further investigation was conducted by computed tomography, endoscopy, and other tests. On the other hand, in order to accurately diagnose the presence of depression, all cases were investigated through a patient interview. None of the cases were investigated by the next step, the administration of a depression screening test. The outcomes included the following: "observation" in 14 cases, and "non-attendance for further follow-up" in 6 cases. We were able to conduct a follow-up telephone interview with 12 of the patients, to determine their current status. The results were as follows: "the symptoms disappeared" in 9 cases; "the symptoms persisted but enduring" in 1 case; and the patient "continued doctor shopping" in 1 case. Conclusion : We tended to instruct the patients with non-specific complaints to conservatively observe their symptoms. However, we have to recognize the need to encourage patients to return for further evaluations when their symptoms continue, as there was a tendency for the patients with non-specific complaints not to return for further evaluation. 2008-08-30T15:00:00Z