著者

福井 花央 片山 修一 後藤 隆文 中原 康雄 大倉 隆宏 人見 浩介 青山 興司

出版者

特定非営利活動法人 日本小児外科学会

雑誌

日本小児外科学会雑誌 (ISSN:0288609X)

巻号頁・発行日

vol.54, no.5, pp.1096-1100, 2018-08-20 (Released:2018-08-20)

参考文献数

13

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卵巣広汎性浮腫massive ovarian edema(以下MOE)は正常の卵胞構造を有したまま,間質の浮腫により卵巣腫大を呈するまれな病態である.我々は女児に発症したMOEの2例を経験したので報告する.症例1は9歳,女児.主訴は食思不振,嘔吐,腹部腫瘤.下腹部正中から右側に,10 cm大の腫瘤を認めた.MRIで骨盤内腫瘤の被膜下にMOEに特徴的な所見であるネックレスサインと呼ばれる多数の小囊胞構造を認めた.術中所見では右卵巣が捻転しており,腫瘍や壊死の可能性を考え付属器切除術を施行した.症例2は4歳,女児.主訴は腹痛,嘔吐.MRIでネックレスサインを認めた.画像,臨床経験から術前にMOEと診断し,腹腔鏡下右卵巣捻転解除術および固定術を施行した.女児の急性腹症ではMOEの可能性を念頭におくべきである.

著者

舟生 富寿 工藤 茂宣 大野 和美 二川原 和男 人見 浩 鈴木 唯司 三国 恒靖 寺山 百合子 青木 敬治 平山 順朗 小野寺 孝夫 菅原 茂

出版者

社団法人 日本腎臓学会

雑誌

日本腎臓学会誌 (ISSN:03852385)

巻号頁・発行日

vol.17, no.9, pp.823-836, 1975-09-30 (Released:2010-07-05)

参考文献数

34

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Metabolism of adrenocortical hormone in patients with chronic impaired renal function was investigated in this study. Urinary 17-OHCS (total, free and fractions-com. F, comp. E, THF, THE) we(re measured by use of thin layer in these 12 patients, including 6 patients who were made to artificial dialysis. Three patients of them were studied on load with ACTH-Z 20 units/day for 3 days intramuscularly and 9 patients were studied on administration of cortisol (1 mg/kg of body weight) intra-venously. Moreover, blood free 11-OHCS was determined in 3 patients with treatment of artificial dialysis. Following results were obtained. 1) The excretion volume of urinary total 17-OHCS remained low coincidently with decrease in creatinine clearance on control, on load with ACTH-Z and on administration of cortisol. 2) In above mentioned patients, the rate of urinary free 17-OHCS to total 17-OHCS exhibited various values which may be influenced with glomerular and tubular lesion, being compared with certain values of normal control. 3) The fractions of urinary 17-OHCS showed small pattern similar to normal control. 4) The excretion pattern of urinary 17-OHCS fractions shifted to cortisol pathway from cortisone pathway on load with ACTH-Z as normal control. 5) In the group with non-hyper BUN, the changes of the excretion volume of urinary 17-OHCS was seemed to be similar to normal control in every 2 hours measurement on administration of cortisol, while in the group with hyper BUN, the changes was not observed. 6) In the patients with artificial dialysis free 11-OHCS remained within normal range but showed abnormal in diurnary variation.