http://hdl.handle.net/10564/1507 1996-08 Fri, 10 Apr 2026 15:25:12 GMT 2026-04-10T15:25:12Z http://hdl.handle.net/10564/747 タイトル: 糖尿病性腎症患者における脂質代謝異常に関する検討 : RLP-コレステロールを中心として 著者: 佐藤, 弘章; 岩野, 正之; 赤井, 靖宏; 栗岡, 英行; 西岡, 久之; 金内, 雅夫; 土肥, 和紘 抄録: Remnant like particle (RLP), which is enriched in apo E and cholesterol esters, refers to lipoproteins that do not have an immunoaffinity to gel mixture of anti-apo A-I and anti-apo B-100 monoclonal antibodies. It is one of the most atherogenic lipo- proteins. High levels of RLP indicate the existence of lipid metabolism disorders. To investigate whether disorders of lipid metabolism exist in patients with non-insulin depen- dent diabetes mellitus (NIDDM), we measured RLP-cholesterol (RLP-C) in 64 patients with NIDDM, 21 patients with impaired glucose tolerance (IGT), and 16 healthy controls. Furthemore, we prescribed bezafibrate (500 mg/day for 3 months), which improves hyper- lipidemia through activating lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL), to 6 patients with NIDDM with high levels of serum RLP-C to assess its effect on lipid metabolism and diabetic nephropathy. The levels of serum RLP-C were higher in the NIDDM group than in the healthy controls. These levels had a correlation with the levels of serum triglyceride (TG), but not with the levels of serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C). The levels of serum RLP-C, TC, and TG decreased after treatment with bezafibrate in all patients, but there was no improve- ment of carbohydrate metabolism or urinary albumin excretion. Our findings suggest that the disorders of lipid metabolism exist in patients with NIDDM, and bezafibrate may be useful in improving these disorders in patients with NIDDM. Fri, 30 Aug 1996 15:00:00 GMT http://hdl.handle.net/10564/747 1996-08-30T15:00:00Z http://hdl.handle.net/10564/746 タイトル: 高度の心機能低下を呈したChurg-Strauss症候群の1例 著者: 濱野, 一將; 上村, 史朗; 中村, 義行; 坂口, 泰弘; 藤本, 眞一; 橋本, 俊雄; 土肥, 和紘 抄録: A 46-year old male with Churg-Strauss syndrome (CSS) was admitted to our hospital because of congestive heart failure. Two years before admitsson, he developed nocturnal episodes of bronchial asthma for 2 weeks. One year before admission, purpura appeared on bilateral lower extremities. He noticed leg edema and exertional dyspnea one month before admission. Blood examination revealed increased eosinophil count (1,491/ μl). Serological test disclosed a marked increase in serum IgE. A chest X ray film showed increase of the cardiac silhouette and bilateral pleural effusion. Echocardiogram revealed an enlargement of the left ventricular dimensions and reduced ejection fraction (EF 31%). The first myocardial biopsy revealed moderate hypertrophy of cardiomyocytes and lymphocyte infiltration. These findings were compatible with myocarditis. Bronchial asthna, eosinophilia, and snymptom of angitis such as myocarditis and skin lesion con- firmed a diagnosis of CSS. Then he was given prednisolone, 20 mg daily. The second myocardial biopsy findings 11 days after prednisolone therapy showed improvement of the inflammation. Three months after corticosteroid administration, echocardiogram showed improvement of the ejection fraction (EF 55%). We report a case of CSS complicated with severe impairment of LV function. During corticosteroid therapy, histological improvement preceded the improvement of left ventricular systolic function. Fri, 30 Aug 1996 15:00:00 GMT http://hdl.handle.net/10564/746 1996-08-30T15:00:00Z http://hdl.handle.net/10564/745 タイトル: 他科との連携を要した新生児症例の検討 著者: 箕輪, 秀樹; 山下, 千賀子; 西久保, 敏也; 野上, 恵嗣; 西村, 龍夫; 河原, 信吾; 奥, 香世; 上辻, 秀和 抄録: To identify current problems in neonatal care in Nara Prefectural Hospital, we retrospectively studied neonates who required consultation with other departments during their hospital stays. The subjects were neonates admitted to our neonatal care unit between April 1, 1992 and September 30, 1995. Two hundred forty-two neonates were admitted and 122 (50.4%) patients required consultaion with twelve other departments for the following reasons : prematurity (90 cases; 54%), congenital abnormality (32 cases; 19 %), accidents during the perinatal period (12 cases; 7%), and others (32 cases; 19%). Sixteen patients were transfered to other hospitals for special treatment, for example, laser photocoagulation for retinopathy due to prematurity, cardiac surgery, or pediatric surgery that could not be performed at our hospital. It is very important for neonatal care to establish good relationships with other departments and to clarify the nature of neonatal diseases. Fri, 30 Aug 1996 15:00:00 GMT http://hdl.handle.net/10564/745 1996-08-30T15:00:00Z http://hdl.handle.net/10564/744 タイトル: 高齢維持透析患者の社会的入院 著者: 金内, 雅夫; 土肥, 和紘 抄録: In order to determine the specific problems associated with sociomedical hospitalization of elderly patients undergoing maintenance hemodialysis, the physical characteristics of these patients and reasons for their hospitalization were investigated. The subjects were 170 patients over 65 years of age undergoing maintenance hemodialysis at 29 dialysis clinics in Nara Prefecture. A questionnaire survey of the staff members of these dialysis clinics was performed. Disturbance of activity of daily living was observed in 77 cases (45.3%) of the subjects. Physical characteristics consisted of renal osteodystro- phy and/or joint disease for 34 patients, cerebrovascular disease for 28, heart failure for 28, dementia for 23, malnutrition for 23, and visual disturbance for 17 patients. Difficulty visiting the outpatient clinic, lack of family support, and loss of self-management abilities were frequent reasons for hospitalization. In conclusion, our findings indicated that sociomedical hospitalization is more common in elderly patients undergoing maintenance hemodialysis. Fri, 30 Aug 1996 15:00:00 GMT http://hdl.handle.net/10564/744 1996-08-30T15:00:00Z