著者

石綿 翔 高木 均 星野 崇 長沼 篤 坂本 直美 小板橋 絵里 相馬 宏光 乾 正幸 工藤 智洋 小川 晃 田原 博貴 金古 美恵子 岡本 宏明

出版者

一般財団法人 日本消化器病学会

雑誌

日本消化器病学会雑誌 (ISSN:04466586)

巻号頁・発行日

vol.109, no.4, pp.624-629, 2012 (Released:2012-04-05)

参考文献数

11

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症例は70歳代女性.全身倦怠感,肝機能障害(ALT 2565IU/l)を主訴に入院.A,B,C型肝炎,EBV,CMV,自己免疫性肝炎は否定.2カ月ほど前から摂取し始めた菊芋によるDLSTで陽性を示し,薬物性肝障害(診断スコア8点)と診断された.その後保存血清でHEV-RNA陽性と判明し,E型肝炎と診断された.DLSTには偽陽性があり薬物性肝障害診断にHEV screeningの導入が必須と考えられた.

著者

設楽 仁 高岸 憲二 下山 大輔 石綿 翔 高澤 英嗣 一ノ瀬 剛 山本 敦史 小林 勉

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.37, no.2, pp.755-759, 2013

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<B>Background:</B> There are many studies about the relationship between brain functional changes and chronic pain such as CRPS, fibromyalgia, osteoarthritis of the knee and chronic back pain.<BR>However there is no study about the relationship between brain functional changes and shoulder disease. The purpose of this study is to clarify the brain functional changes regarding to shoulder pain using functional magnetic resonance image (fMRI) in rotator cuff tear (RCT) patients.<BR><B>Methods:</B> Nine healthy volunteers and 9 RCT patients participated in this study. Brain activation was examined by fMRI technique (3 Tesra-MRI). We applied an active shoulder motion task and a motor imagery task during fMRI.<BR><B>Results:</B> In the active shoulder motion task, there was significant activation in the right premotor cortex, right primary somatosensory cortex, right superior parietal lobule, bilateral prefrontal cortices, right intraparietal sulcus, anterior cingulate cortex, left lingual gyrus and left cerebellum in RCT group compared to normal group.<BR>In the motor imagery task, there were brain activities in the left prefrontal cortex and supplementary motor area which was related to the pain matrix despite the absence of feeling pain in RCT group compared to normal group. <BR><B>Conclusion:</B> The current study reveals that RCT can cause reorganization of the central nervous system, suggesting that such an injury might be regarded as a neurophysiologic dysfunction, not a simple peripheral musculoskeletal injury. This study is the first evidence that the pain with RCT is related to the brain functional change.