著者

石賀 信史 岩本 伸二 庄 達夫 石原 清宏 酒井 邦彦 岩藤 真治 山本 泰久

出版者

The Japan Society of Coloproctology

雑誌

日本大腸肛門病学会雑誌 (ISSN:00471801)

巻号頁・発行日

vol.43, no.1, pp.108-112, 1990 (Released:2009-10-16)

参考文献数

18

被引用文献数

2

---

大腸内視鏡で虫体を確認した大腸アニサキス症の1例を経験したので報告する.患者は48歳男性, 1988年11月13日夕食時にサバ寿司を食したが, その2日後より右下腹部痛を訴えて来院した。右下腹部に強い圧痛と筋性防御を認めるが腹部腫瘤は触知しなかった.血液検査では9800/mm3と白血球数の増加を認めたが好酸球数は正常範囲内であった.腹部超音波検査で盲腸から上行結腸にかけての粘膜下層の著明な浮腫を認めた.以上より大腸アニサキス症がもっとも疑われ大腸内視鏡を施行した.大腸内視鏡では発赤, 浮腫著明な上行結腸粘膜に刺入したアニサキス虫体を確認し, 鉗子にてこれを摘出した.その後症状は速やかに改善し5日後に軽快退院の運びとなった.

著者

酒井 邦彦 笠原 孝治

出版者

時事通信社

雑誌

厚生福祉

巻号頁・発行日

no.6216, 2016-01-29

著者

大島 博幸 酒井 邦彦 高木 健太郎 池上 茂

出版者

社団法人 日本泌尿器科学会

雑誌

日本泌尿器科學會雑誌 (ISSN:00215287)

巻号頁・発行日

vol.65, no.11, pp.732-740, 1974-11-20 (Released:2010-07-23)

参考文献数

44

---

Eleven cases of true hermaphrodites were investigated with special reference to the relationship between differentiation of gonads and development of sexual duct systems. On most of them were performed studies of the sex chromatin, fluorescent body and chromosomal analysis. Also, reported cases in Japan as well as in foreign countries were collected and reviewed.Chromosomal analysis on 9 cases revealed chromosomal constitutions of 46, XX in 3 cases, 46, XY in 4 and 46, XX/46, XY in 2.Four cases out of 5 patients with a testis at one side and an ovary at the opposite showed Y-bearing chromosomal constitutions. Most of reported cases with a similar type of gonadal developement as the above mentioned were proved to have Y chromosome in their stem cells.Analysis of chromosomes in myelocytes and lymphocytes from a patient with 46, XX/46, XY revealed an interesting result. Twenty-one myelocytes out of 24 had chromosomal constitution of 46, XY and only 3 had 46, XX, whereas almost all of lymphocytes investigated after culture of peripheral blood had 46, XX constitution. It may be suggested from the above finding that cell populations are different from one tissue to another and may influence the differentiation of the primordial gonad toward a testis or ovary. It was another interesting finding that the fluorescent body was observed in 19% of lymphocytes from the patient mentioned above. The observation indicates the importance of examining Barr body as well as fluorescent body on more than two kinds of tissues, because native cells without cell-culture can be utilized for the examinations.Six true hermaphrodites investigated for both Barr and fluorescent bodies consisted of two of 46, XX, 46, XY and 46, XX/46, XY, respectively. Both bodies were positive in each case with mosaicism 46, XX/ 46, XY, although their frequencies were at lower percentage than normal female or male. On the other hand, only a few Barr or fluorescent bodies were recognized in each case of 46, XY or 46, XX, respectively. It is difficult to decide whether the above results were caused by an unrecognized mosaicism or not.From the observations of true hermaphrodites and XX-males, there has been raised an assumption that a sex-determining factor may locate on one of autosomes to which Y chromosome may affect as a regulating factor. This assumption, however, appears not sufficient to explain the differentiation of the ovarian tissue in the case of 46, XY.Testes in the foetus stimulate the differentiation and development of the Wolflian duct and suppress the Mullerian duct. The former function appears to be controlled by one of androgens secreted from the foetal testis. From the observation of clinical cases and animal experiments, the latter function seems to be closely related to the chromosomal constitution of cells composing the ductal tissue, while this function must be mediated by a chemical messenger produced from the foetal testis.