著者

金澤 太茂 小長谷 敏浩 今村 祐志 金山 範明 松永 昌宏 大平 英樹 福山 誠介 篠田 淳 野村 理朗 野木森 剛 金子 宏 各務 伸一

出版者

愛知医科大学

雑誌

愛知医科大学医学会雑誌 (ISSN:03010902)

巻号頁・発行日

vol.35, no.2, pp.59-70, 2007-06

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Background: Brain activation areas in relation to bowel stimuli have been reported using brain imaging techniques in patients with irritable bowel syndrome(IBS). However, the results are controversial. The aim of this study is to clarify responsible brain site(s) when stimulated by the rectal balloon distension-induced abdominal symptom in IBS in terms of braingut interactions. Methods: Seven healthy volunteers and five patients with diarrhea-predominant IBS based on the Rome II criteria were recruited. All were right-handed men. Rectal sensitivity was examined with balloon distension using a barostat device. Studies are performed with or without rectal distension(RD). Each task took 4 minutes. The subjects were assigned to have each twice task at the individual pain threshold level with 11 minute intervals. The changes in brain blood flow were evaluated using H_2 ^<15>O-water positron emission tomography. Subjects were asked rectal pain and stress level with visual analogue scale(VAS) before and soon after the respective task. Blood pressure, heart rate, and several serum stress-related substances were also investigated. Results: The threshold of pressure for rectal pain was significantly lower in the IBS patients(IBS=14.4mmHg, volunteers=26.3mmHg on average). The IBS patients showed a significant increase in blood flow in especially insula, and in thalamus at RD as compared with that in volunteers. Analyzing changes in VAS score before and after task, an increase of score about physical stress was significantly larger in the IBS patients in RD although no differences was noted in pain perceived score among all subjects in RD. A tendency of correlation was observed between the RD-induced increment in blood flow in insula and that in VAS score of stress-feeling. Conclusions: The IBS patients had a significantly lower pain threshold against RD. Under RD stress at an individual pain threshold, a significant objective activation in insula, subjective physical stress, and correlation between them were obtained, indicating the brain activation magnitude-correlated stress in IBS.

著者

今村 祐志

出版者

一般社団法人 日本消化器内視鏡学会

雑誌

日本消化器内視鏡学会雑誌 (ISSN:03871207)

巻号頁・発行日

vol.60, no.8, pp.1444-1449, 2018 (Released:2018-08-20)

参考文献数

31

被引用文献数

2

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A型胃炎とは自己免疫性胃炎のことであり,自己免疫的機序により胃底腺領域の高度粘膜萎縮および化生を認め,ビタミンB12や鉄などの吸収障害が起こり,神経内分泌腫瘍や胃癌を合併しうる.特徴的な所見は,胃底腺領域の萎縮を内視鏡や生検組織などで認め,抗壁細胞抗体や抗内因子抗体が陽性となり,ガストリン値が高値,ビタミンB12が低値となる.治療法はなく,ビタミンB12や鉄などの補充を行うとともに,胃癌のサーベイランス,合併症の検索を行う.診断されていない症例が多いと考えられ,自己免疫性胃炎を鑑別に挙げることが大切である.

著者

塩谷 昭子 鎌田 智有 今村 祐志 楠 裕明 畠 二郎 春間 賢

出版者

日本臨床検査医学会事務所

雑誌

臨床病理 (ISSN:00471860)

巻号頁・発行日

vol.57, no.9, pp.870-875, 2009-09-25