DSpace コレクション: 1997-12

第118回奈良医学会 : 学会記事

Tue, 30 Dec 1997 15:00:00 GMT

タイトル: 第118回奈良医学会 : 学会記事

血行性腎カンジダ症による急性腎不全を合併した胃幽門部癌の1例

Tue, 30 Dec 1997 15:00:00 GMT

タイトル: 血行性腎カンジダ症による急性腎不全を合併した胃幽門部癌の1例著者: 川田, 啓之; 西野, 俊彦; 椎木, 英夫; 川本, 篤彦; 金内, 雅夫; 土肥, 和紘; 藤尾, 陽一抄録: A 67-year-old man was referred to our hospital because of high-grade fever and acute renal failure on January 11, 1996. Gastroduodenal fiberscopy performed 17 days before admission revealed advanced gastric cancer in the pylorus. Intravenous hyper- alimentation was started on December 27, 1995. Because of the fever, the patient had been treated with 5mg/day of indomethacin and 2g/day of cefazolin since January 1, 1996. Serum creatinine was elevated to 8.2mg/dl. To rule out acute interstitial nephritis caused by these drugs, a renal biopsy was performed on the second hospital day. The biopsy specimen demonstrated multiple microabscesses containing yeast-like organisms in the medulla. Candida tropicalis was isolated from urine cultures, atrial blood and the catheter tip. The patient was diagnosed as having acute renal failure due to renal candidiasis. Under hemodialysis treatment, he received 400mg/day of miconazole. Hemodialysis was stopped on the 13th hospital day. On the 41st hospital day, the patient was afebrile and serum creatinine had decreased to 1.7mg/dl. We present a case of acute renal failure due to renal moniliasis caused by hematogenous infection with Candida tropicalis, and discuss the related literature.

90歳女性の巨大腹壁膿瘍を合併した結腸癌の1例

Tue, 30 Dec 1997 15:00:00 GMT

タイトル: 90歳女性の巨大腹壁膿瘍を合併した結腸癌の1例著者: 久我, 由紀子; 藤井, 謙裕; 山野, 繁; 橋本, 俊雄; 土肥, 和紘; 福岡, 喜晃; 小西, 陽一抄録: A 90-year-old female was admitted to our hospital because of fever and swelling in the left lower quadrant. There were severe hypoproteinemia and inflammatory reaction in her laboratory data. Giant abscess formation in the abdominal wall was revealed by ultrasonography and CT scan. About 2,000ml volume discharge from the abscess was evident on the surgical drainage. Bacteroides, Fusobacterium, Enterobacter- iaceae and Escherichia coli were detected by the culture from the abscess. Colonoscopy revealed a sigmoid colon cancer. In the course of the conservative treatment, a discharge with feces from the abscess was evident. This patient was found to have a giant abscess of abdominal wall due to development of sigmoid colon cancer.

NITRIC OXIDE SYNTHASE INHIBITOR SUPPRESS THE VASOCONSTRIC-TION DUE TO SEVOFLURANE IN CEREBRAL PIAL ARTERIES LARGER THAN 100μm IN DIAMETER IN CATS

Tue, 30 Dec 1997 15:00:00 GMT

タイトル: NITRIC OXIDE SYNTHASE INHIBITOR SUPPRESS THE VASOCONSTRIC-TION DUE TO SEVOFLURANE IN CEREBRAL PIAL ARTERIES LARGER THAN 100μm IN DIAMETER IN CATS 著者: Syohda, Asao 抄録: Background Nitric oxide (NO) plays an important role in the reactivity of cerebral circulation to various stimuli. It is still unclear whether NO mediates the effect of sevoflurane on cerebral circulation. We therefore examined this question by measuring the diameter of pial arteries with or without exposure to NO synthase inhibitor, N ω-nitro-L -arginine methyl ester (L-NAME). Methods The cranial window technique was employed in experiments using seven cats that received fentanyl and midazolam under mechanical ventilation. Diameters of cerebral pial arteries were observed through the cranial windows using an incident-light fluorescence microscope and video-recorded with a silicon-intensified target tube video camera system. Changes in arterial diameter were measured with an image analyzer after the experiments were finished. The diameters of pial arteries were measured under four conditions follow- ing the protocol below : 1) intravenous anesthesia ; 2) intravenous plus sevoflurane anesthe- sia; then after L-NAME infusion, 3) intravenous anesthesia ; and 4) intravenous plus sevoflurane anesthesia. Changes in vessel diameter were analyzed. Results The arteries larger than 100μm were significantly constricted (p<0.05) under sevoflurane inhalation ; in contrast, after the administration of L-NAME, the arteries were not significantly affected by sevoflurane inhalation. Conclusion L-NAME inhibited the vasoconstriction due to sevoflurane inhalation in cere- bral pial arteries larger than 100μm. In the cerebral pial arteries larger than 100μm in diameter, NO synthesis was shown to be involved in vasoconstriction due to sevoflurane inhalation.