著者

船曳 康子 北 徹 石井 賢二 日下 茂 袴田 康弘 若月 芳雄 村上 元庸 横出 正之 久米 典昭 堀内 久徳

出版者

一般社団法人 日本老年医学会

雑誌

日本老年医学会雑誌 (ISSN:03009173)

巻号頁・発行日

vol.36, no.4, pp.274-278, 1999

被引用文献数

10

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症例は83歳男性. 1996年12月末より徐々に喀痰, 咳嗽, 全身倦怠感, 食欲低下みられ当院受診. 肺炎と診断され1997年1月7日入院となった. 入院時血圧70/48mmHg, PaO2 55.5mmHg, CRP20mg/dl, ラ音聴取, 黄色膿性痰みられ, 抗生剤を開始した, 血清抗体価の上昇より (入院時4倍→2週後128倍), インフルエンザA感染症の合併と診断した. 発熱, 呼吸困難は抗生剤治療に抵抗性であった. 血中よりアスペルギルス抗原を検出し (2+), 抗真菌剤治療により抗原は (1+) と改善したが, 2月20日, 喀血をきたし永眠された, アスペルギルス症は免疫不全患者が罹るとされているが, 本例では入院後数日間白血球数が低下しており, インフルエンザによる一時的免疫力低下がアスペルギルス症の発症に関与したと考えられた. また高齢者のインフルエンザ感染症の合併症の重篤さが示唆された.

著者

堀 克弘 吉川 玄逸 平岡 誠司 松末 吉隆 村上 元庸

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.27, no.3, pp.455-458, 2003-10-30 (Released:2012-11-20)

参考文献数

7

被引用文献数

1

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A rupture of the rotator cuff tendon may induce muscular fatty degeneration, which can be observed with computed tomography (CT) imaging. The purpose of this study was to examine the frequency of fatty degeneration in patients with a complete rotator cuff tear using CT images.Twenty shoulders in twenty eight patients (average age sixty point seven years old ) with a complete cuff tear were studied. Fatty degeneration was evaluated using CT images and assessed by Goutallier's classification. The diagnosis of rotator cuff tear was made by the examiner, after which the frequency of fatty degeneration was determined. Supraspinatus tendon ruptures were found in eleven patients, infraspinatus tendon ruptures in two, supraspinatus and infraspinatus tendon ruptures in six, supraspinatus and subscapularis tendon ruptures in eight, and all three tendons were found ruptured in three. The frequency of fatty degeneration in the infraspinatus tendon was 66.7%, while that in the supraspinatus and subscapularis tendons was 35.7% and 23.1%, respectively. Some reports have concluded that postoperative results for rotator cuff repair are inferior when fatty degeneration has occurred, thus, it is best if surgery can be performed prior to its appearance. From the results of the present study, we considered that fatty degeneration is more prevalent with the infraspinatus tendon. Therefore, when a rupture of the this tendon is suspected, an operation should be carried out as soon as possible.

著者

村上 元庸 小島 保二 前田 敏博 牧川 方昭 福田 眞輔

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.15, no.1, pp.4-8, 1991

被引用文献数

2

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Sensory nerve endings in the monkey shoulder joint capsule were observed by light microscopy. The nerve staining technique was based upon Tago's method which was very sensitive for acetylcholinesterase (Ach E) existing in the peripheral nerve.<BR>Three distinct sensory nerve endings have b een identified: free nerve endings, Ruffini-type corpuscles, and Pacini-type corpuscles.<BR>Ruffini-typc corpuscles a n d Pacini-type corpuscles, which were thought to act as mechanoreceptors, were mainly localized in the transitional portion between the labrum and the capsule, but not within the labrum.<BR>Free ne r ve endiings, which may function as nociceptors (Pain), were distributed widely in the capsule and also in th labrum.<BR>As the results demo n strated that may mechanoreceptors exist in the capsule, it is presumed that the capsule acts not only as a static stabilizer, but also as a sensory apparatus for stress, and plays an important role in the dynamic stabilizing system. It seems that the location of the mcchanoreceptors is the optimum place for sensors to respond to the resultant force which dislocates the humeral head.<BR>Finally, we hypothesize that the dynamic stabilizing effect is performed by a series of reflex effects from the capsule to the surrounding muscle of the shoulder.

著者

村上 元庸 牧川 方昭 前野 幹幸 畑 正樹 七川 歓次

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.1, pp.22-24, 1986-07-28 (Released:2012-11-20)

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When abducting the arm, the scapula and the humerus move cooperatively. This cooperation is known as “scapulohumeral rhythm”, and a constant relationship is said to exist between the abduction angle of the humerus and that of the scapula.But since the glenoid is too small to support the humeral head, it may happen that the humeral head will be dislocated or the soft tissue, like tendons or capsule, will be exposed to a excessive load, if the resultant force through the humeral head does not directly face to the glenoid. So we guess that a change of the resultant force which is consist of load and muscle power to the humerus may change the incline of the glenoid even at the same humeral abducting angle.In this study, we investigated the relationship between the glenoid inclination angle and the humeral abduction angle with or without block of the supraspinatus muscle power by the suprascapular nerve block.The subjects of this experiment was 5 healthy men, and the angle was measured by X-ray films which were taken at every 45 degrees abduction position with voluntary effort to abduct isometrically before and after the nerve block, and also the abduction torque was measured simultaneously by the Cybex- II.The result was that the inclination angle of the scapula was decreased after block, as the maximum defference at 90 degree abduction by 6 degree. And the torque was decreased by the mean of 25 %.From our hypothesis that the resultant force faces the glenoid perpendicularly, these results could be explained by the functional anatomy of the supraspinatus tendon. At 0 and 135 degree abduction the supraspinatus runs perpendicularly to the glenoid, so the resultant force does not change the direction after block. But at 90 degree abduction the position of the insertion of the supraspinatus is the highest of all abduction angle, so it acts to pull down the head. The resultant that force after block changes the direction upward, and so the glenoid inclination angle decreases to face the head.From these results, we guess a resultant force to the humeral head always faces to the glenoid by controlled constraction of the muscles around the shoulder.

著者

村上 元庸 小島 保二 前田 敏博 牧川方 昭 福田 眞輔 畑 正樹 吉川 玄逸

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.16, no.1, pp.96-102, 1992

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An ultrastructural study of the sensory nerve endings in monkeys' shoulder joints was undertaken, stained by Tago's method, which is the histochemical staining of acetylcholinesterase.<BR>The Pacini-type corpuscle is oval in shape and it consists of inner and o uter cores. At the center of the inner core, there is an unmyelinated axon terminal. The axon terminal has numerous mitocondoria. The lamellated inner core is composed of Schwann cell processes. Reaction products are found in the space between the axon terminal and the lamellar cell processes, in the interlamellar spaces and in some caveolae.<BR>In the Ruffini-typ e corpuscle, the axon terminal loses its mylin sheath and branches several times. The axon terminals are incompletely surrounded by a Schwann cell cytoplasm. The axon terminal has numerous mitochondoria and agranular vesicles. The Schwann cell cytoplasm surrounds a bundle of collagen fibrils. The reaction products are found between the axon terminal and the Schwann cell cytoplasm, and also around the Schwann cell cytoplasm.<BR>From their characteristic structure, it seems that the Pac i n i-type corpuscles respond to a pressure force from the humeral head. While the Ruffini-type corpuscles respond to a stretch force. The latter were thought to have a more important role as sensors of a dynamic stabilizing system.

著者

土肥 潤二 村上 元庸 吉川 玄逸 福田 眞輔

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.19, no.1, pp.108-111, 1995-05-20 (Released:2012-11-20)

参考文献数

8

被引用文献数

1

著者

斉田 宏 村上 元庸 関 真理 三宅 健夫

出版者

The Japanese Society of Gastroenterology

雑誌

日本消化機病學會雜誌. 乙 (ISSN:13497693)

巻号頁・発行日

vol.81, no.1, pp.16-21, 1984

被引用文献数

9

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レーザードップラー法 (LDV) によるラット胃粘膜血流測定を接触電極法による水素ガスクリアランス法との比較において検討した.<br>胃粘膜血流を反映する接触式水素ガスクリアランス法による血流値とLDVによる電気信号とは有意の (p<0.01) 相関を認めた.<br>又, 再現性も高く, 繰り返しの測定が可能であつた. LDVは, 時々刻々変化する粘膜血流に対して敏感に応答しながら連続的に記録する事が可能であり, 水素ガスクリアランス法にて測定不能な低血流をも容易に測定できた. 以上よりLDVは, 胃粘膜血流測定に有用な方法であり, 胃粘膜防御機構の一つである粘膜血流の研究に更に有効な手段となり得ると結論した.