著者

杉浦 正彦 田辺 安忠 菅原 瑛明 木村 桂大 竹川 国之 大山 聖 佐藤 允 金崎 雅博 岸 祐希 SUGIURA Masahiko TANABE Yasutada SUGAWARA Hideaki KIMURA Keita TAKEKAWA Kuniyuki OYAMA Akira SATO Makoto KANAZAKI Masahiro KISHI Yuki

出版者

宇宙航空研究開発機構(JAXA)

雑誌

宇宙航空研究開発機構特別資料: 流体力学講演会/航空宇宙数値シミュレーション技術シンポジウム2020オンライン論文集 = JAXA Special Publication: Proceedings of Fluid Dynamics Conference / Aerospace Numerical Simulation Symposium 2020 Online (ISSN:24332232)

巻号頁・発行日

vol.JAXA-SP-20-008, pp.157-164, 2021-02-08

---

流体力学講演会/航空宇宙数値シミュレーション技術シンポジウム2020オンライン (2020年9月28日-30日. 日本航空宇宙学会 : 宇宙航空研究開発機構(JAXA)オンライン会議)

著者

春木 伸裕 佐藤 篤司 杉浦 正彦 呉原 裕樹 辻 秀樹

出版者

日本腹部救急医学会

雑誌

日本腹部救急医学会雑誌 (ISSN:13402242)

巻号頁・発行日

vol.30, no.3, pp.487-490, 2010-03-31 (Released:2010-05-11)

参考文献数

15

被引用文献数

4

---

症例は1型糖尿病で通院中の55歳女性で,インスリン注射を3日前から自己中断し意識障害を呈し入院となった。血液検査にて糖尿病性ケトアシドーシスと診断し治療を開始した。翌日38℃の発熱と腹部膨満を訴えたため,緊急CTを施行した。腹水,門脈ガス,広範な腸管気腫を認め,腸管壊死による急性腹膜炎と診断し緊急手術を施行した。開腹すると,回腸末端の約200cmの回腸が分節的に壊死しており,S状結腸も暗紫色を呈し虚血に陥っていた。上腸間膜動脈および下腸間膜動脈は本幹から末梢まで拍動を触知できたことから,非閉塞性腸管膜虚血症(nonocclusive mesenteric ischemia: 以下,NOMI)と診断し,壊死した腸管の切除と下行結腸に人工肛門を造設した。NOMIは主幹動脈に器質的閉塞がないにもかかわらず,腸管に虚血あるいは壊死を生じる予後不良の疾患で,自験例は著明な脱水と,高血糖による高浸透圧が増悪因子となり,NOMIを発症したものと考えられた。

著者

森 昭裕 梶田 和男 山北 宜由 森田 浩之 村井 敏博 安田 圭吾 杉浦 正彦 三浦 清

出版者

一般社団法人 日本内分泌学会

雑誌

日本内分泌学会雑誌 (ISSN:00290661)

巻号頁・発行日

vol.67, no.10, pp.1147-1161, 1991-10-20 (Released:2012-09-24)

参考文献数

23

被引用文献数

1 1

---

Recently several types of anti-pituitary-antibodies (APA) have been found in patients with pituitary disorders including hypopituitarism and diabetes incipidus, and in postpartum women. However, the pathophysiological role(s) of APA still remains unknown. In order to elucidate the clinical significance of APA, longitudinal follow-up and family study of APA in patients with hypopituitarism were performed.APA in serum was examined in a total of 11 patients with various types of hypopituitarism (7 of isolated ACTH deficiency, 1 of partial hypopituitarism, 3 of Sheehan's syndrome, 6 males and 5 females). Chronic thyroiditis was associated in 3 out of 7 patients with isolated ACTH deficiency, and empty sella was found in each one patient with isolated ACTH deficiency and partial hypopituitarism, and in 3 patients with Sheehan's syndrome. APA was examined on 2 or 3 occasions at more than a 6 month interval (longitudinal study). In 5 patients, their 16 family members were examined for the presence of APA, and pituitary functions were evaluated in 3 out of 7 family members with positive APA (family study). For pituitary function tests, arginine infusion test, TRH, LH-RH or CRH test and insulin tolerance test were performed. APA reacting to rat pituitary cytoplasmic antigens (pituitary cell antibodies: PCA) and APA reacting to rat GH3 cells and/or mouse AtT20 cells surface antigens (pituitary cell surface antibodies: PCSA) were assayed with indirect immunofluorescence method.At the initial examination, 6 out of 11 patients (55%) showed positive APA. Thepatients were divided into 3 subgroups according to the longitudinal study: the group with disappearance of initially positive APA (3 patients), the group with altered titers or types of initially positive APA (3 patients), and the group with sustained initially negative APA (4 patients). No effects of replacement therapy on the alterations of APA were observed.In 16 family members of 5 patients (each 1 with partial hypopituitarism and isolated ACTH deficiency syndrome, and 3 with Sheehan's syndrome), APA in their sera were investigated. Seven out of 16 members (44%) showed positive APA. Among 6 first-degree relatives of 16 family members, both or either one of APA and PCSA were positive in 4 (67%). Out of 10 of their second- or third-degree relatives, 3 (30%) were positive for PCA or PCSA. All of 3 relatives with positive APA studied showed mild pituitary hypofunction without any clinical manifestations.These results suggest the possibility that autoimmune mechanism-induced hypofunction as well as hereditary background might participate in the pathogenesis of some hypopituitarism, and that APA might have a causative role in such disorders.