著者

伊藤 保彦 五十嵐 徹 立麻 典子 今井 大洋 吉田 順子 土屋 正己 村上 睦美 福永 慶隆

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.66, no.4, pp.239-244, 1999-08-15 (Released:2000-04-12)

参考文献数

27

被引用文献数

1 1

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We have encounted two patients with fibromyalgia (FM) initially diagnosed as having autoimmune fatigue syndrome (AIFS). To investigate the relationship between AIFS and FM, the distribution of the tender points in patients with AIFS was assessed according to the ACR criteria for FM. It was revealed that AIFS patients had 5.6 tender points on averages. Patients with headaches, digestive problems, or difficulty going to school had more tender points than patients without. Patients with ANA titers

著者

Tatsuya Nomoto Takehiro Seta Koichi Nomura Yukihiro Shikama Tadashi Katagiri Ken-ichiro Katsura Takeo Kato Yasuo Katayama

出版者

The Medical Association of Nippon Medical School

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.74, no.3, pp.261-264, 2007 (Released:2007-07-12)

参考文献数

6

被引用文献数

3 8

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Recently, an outbreak of acute encephalopathy associated with Sugihiratake mushroom ingestion has been reported in northern Japan. Patients with chronic kidney diseases are thought to be at risk for severe encephalopathy following Sugihiratake mushroom ingestion. We report a case of encephalopathy associated with Sugihiratake mushroom ingestion in a patient with diabetic nephropathy. Brain magnetic resonance imaging showed discriminative intensity in the medial temporal lobe, claustrum, and insula cortex bilaterally. Cerebrospinal fluid examination revealed mildly elevated protein and marked elevation of myelin basic protein without pleocytosis. Twenty-five days after admission, these signal-intensity changes had markedly improved, and the patient was discharged without sequelae. Although the exact mechanism of this acute encephalopathy remains undetermined, demyelination is believed to be a possible associated pathological change. In cases of encephalopathy of undetermined cause with distinct magnetic resonance findings, Sugihiratake mushroom intoxication should be considered in areas where ingestion of this mushroom is common.

著者

北川 亘 清水 一雄 赤須 東樹 田中 茂夫

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.70, no.1, pp.57-61, 2003 (Released:2003-02-24)

参考文献数

11

被引用文献数

9 12

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Thyroid disease is comparatively prevalent, and it is important to perform careful palpation of the anterior neck when patients are first examined. In this paper, the latest data on and clinical characteristics of the epidemiology of thyroid carcinoma are described.According to Japanese cancer statistics, in 1996, the number of cases of thyroid carcinoma was 1,390 men and 5,437 women. The female to male ratio was 3.91: 1. The crude rate of thyroid carcinoma per 100,000 population was 2.3 men and 8.5 women. The age-adjusted incidence rate showed a gradual increase with age, and the peak of the age-adjusted incidence rate was over 80 years old among men, and from 70 to 80 years old among women.According to the Japanese Thyroid Cancer Registration Committee, from 1977 to 1999, papillary thyroid carcinoma accounted for more than 85% (30,256) of thyroid carcinomas among 35,312 patients. Medullary thyroid carcinoma (1.4%) and anaplastic thyroid carcinoma (1.6%) were rare. The female to male ratio of thyroid carcinoma was 6.1: 1. Registration was made in accordance with the general rules issued by the Japanese Society of Thyroid Surgery. According to the vital statistics, mortality related to thyroid carcinoma among all cancer-related deaths was 0.23% among men (411) and 0.76% among women (887) in 2000. The female to male ratio of mortality was 2.16: 1. The peak of mortality was from 70 to 80 years old among men, and from 80 to 90 years old among women.Most patients with differentiated thyroid carcinoma had a low mortality rate, but anaplastic carcinoma had a poor prognosis. Lung and bone were the main distant metastatic sites, and respiratory insufficiency was the most common specific fatal condition.

著者

坂本 篤裕

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.70, no.1, pp.66-68, 2003 (Released:2003-02-24)

参考文献数

5

被引用文献数

2 2

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Erythromelalgia is a rare condition that is characterized by the triad of redness, increased temperature, and intense pain of feet or hands. This syndrome was first described in 1878, however, universal classification, precise mechanism and successful medical treatment of erythoromelalgia have not been described. We experienced 3 cases of erythomelalgia in our outpatient pain clinic that showed the different progress. One patient experienced the long-term pain complicated with neuropathic pain. The pain of other two patients was eliminated early by nerve block treatments, and they did not showed chronic pain. From the prophylactic viewpoint of chronic pain, the most considerable matter is early and certain elimination of severe pain under certain diagnosis. In this article, the mechanisms of passing into the chronic pain state as well as the efficacy of neural blockade for intractable pain such as erythromelalgia are discussed.

著者

Seiichi Shinji Takeshi Yamada Akihisa Matsuda Hiromichi Sonoda Ryo Ohta Takuma Iwai Koki Takeda Kazuhide Yonaga Yuka Masuda Hiroshi Yoshida

出版者

The Medical Association of Nippon Medical School

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.89, no.3, pp.246-254, 2022-06-25 (Released:2022-06-28)

参考文献数

80

被引用文献数

56

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Colorectal cancer (CRC) is the third most common cancer worldwide, and surgical treatment remains the first-line treatment to provide a cure. In addition to the aging population, obesity, low physical activity, and smoking habits increase CRC risk. Despite advances in surgical techniques, chemotherapy, and radiotherapy, colorectal cancer remains the second leading cause of cancer-related deaths worldwide. For early-stage CRC, endoscopic treatment, including endoscopic mucosal resection and endoscopic submucosal dissection, has been performed. However, lymph node dissection is an integral part of surgical treatment for advanced-stage cancer because of the high incidence of lymph node metastasis. Conventional open surgery has evolved into laparoscopic and robotic surgery. Although prospective studies have confirmed the safety and feasibility of laparoscopic surgery for CRC, relevant treatment models of transverse colon cancer and rectal cancer still need to be further explored and validated. Furthermore, multidisciplinary treatment is needed to cure CRC completely. This review aimed to provide an update on recent advances in the surgical treatment of CRC.

著者

Hidehisa Saeki

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.84, no.1, pp.2-11, 2017-01-15 (Released:2017-03-22)

参考文献数

37

被引用文献数

15

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The guidelines for the treatment of atopic dermatitis (AD) issued by the Japanese Dermatological Association (JDA), which are basically designed for dermatologists, were first prepared in 2000 and revised in 2016. The guidelines for AD of the Japanese Society of Allergology (JSA), which are basically designed for allergologists, including internists, otorhinolaryngologists, ophthalmologists, and dermatologists, were first prepared in 2009 and revised in 2014. In this article, I review the definition, pathophysiology, etiology, epidemiology, diagnosis, severity classification, examination for diagnosis and severity assessment, and treatments for AD in Japan according to these two guidelines for AD (JDA and JSA). Based on the definition and diagnostic criteria for AD of the JDA, patients meeting three basic criteria, 1) pruritus, 2) typical morphology and distribution of the eczema, and 3) chronic or chronically relapsing course, are regarded as having AD. Treatment measures for AD basically consist of drug therapy, skin care, and elimination of exacerbating factors. Drugs that potently reduce AD-related inflammation in the skin are topical corticosteroids and tacrolimus. It is most important to promptly and accurately reduce inflammation related to AD by using these topical anti-inflammatory drugs. Proactive therapy refers to a treatment method in which, after inducing remission, a topical corticosteroid or tacrolimus ointment is intermittently applied to the skin in addition to skin care with moisturizers in order to maintain remission.

著者

山内 栄五郎 熊野 玲子 小林 憲 服部 貴行 松本 純一 大西 毅 早川 美奈子 谷 一朗

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.69, no.5, pp.471-475, 2002 (Released:2002-10-25)

参考文献数

16

被引用文献数

22 19

著者

茨木 信博

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.69, no.4, pp.404-405, 2002 (Released:2002-08-23)

参考文献数

10

著者

Tsutomu Igarashi Yuri Nakazato Tomoyuki Kunishige Miho Fujita Yumi Yamada Chiaki Fujimoto Kimihiro Okubo Hiroshi Takahashi

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.79, no.3, pp.182-189, 2012 (Released:2012-07-05)

参考文献数

24

被引用文献数

1 7

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Background: Recent studies have examined the effects of intranasal corticosteroids (INSs) in relieving the ocular symptoms of seasonal allergic rhinoconjunctivitis (SAR) and perennial allergic rhinitis. However, because most of these studies were based on subjective assessments by patients, the associated factors and mechanism of action are unknown. Methods: A single-center, randomized, double-blind, parallel-group study was carried out in which patients with SAR were randomly assigned to an INS mometasone furoate nasal spray (MFNS) group or to a placebo group and treated once daily for 4 weeks. Substance P concentrations in tears were measured, ocular and nasal symptoms were recorded by patients in an allergy diary, and findings were recorded by an ophthalmologist. Results: There was no significant difference between treatment groups in the mean change from baseline of substance P concentration in tears after 4 weeks of treatment, but the mean change tended to increase in the placebo group and tended to decrease in the MFNS group (P = 0.089). All ocular and nasal symptom scores, except eye tearing, were significantly lower in the MFNS group than in the placebo group. Furthermore, substance P concentrations were strongly correlated with ocular and nasal symptom scores. Conclusions: In patients with SAR, INSs tend to decrease the substance P concentration in tears, which is correlated with the severity of ocular and nasal symptoms.

著者

山寺 博史

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.68, no.4, pp.344-348, 2001 (Released:2001-12-28)

参考文献数

19

被引用文献数

2 1

著者

林 敏彦

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.67, no.3, pp.222-223, 2000 (Released:2001-10-25)

著者

Tomokazu Motomura Hisashi Matsumoto Kunihiro Mashiko Hirotoshi Ishikawa Tetsuya Nishimoto Yoshihiro Takeyama

出版者

The Medical Association of Nippon Medical School

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

pp.JNMS.2020_87-406, (Released:2020-03-31)

被引用文献数

5

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IntroductionTo increase survival rates among patients with severe trauma from road traffic accidents, Japan launched the D-Call Net (DCN) system for dispatching doctors by helicopter utilizing Advanced Automatic Collision Notification technology in November 2015. As of October 2019, DCN has dispatched doctors 4 times.CasesCase 1: Canceled because trauma was mild. Case 2: Doctor made contact with 2 patients with moderate trauma 29 min earlier than would have occurred conventionally. This was the first case of doctor dispatch and patient treatment based on automotive engineering information worldwide. Case 3: An accident involving 3 severely injured patients activated DCN, enabling doctor-patient contact 20 min earlier than would have been possible conventionally. Case 4: DCN was utilized ineffectively.DiscussionAccording to 2008 data from Chiba Prefecture, in accidents where victims sustained severe trauma, the time from accidence occurrence to hospital arrival was 67 min, even with doctor dispatch by air ambulance ("Doctor-Heli" [DH]). Accident information for faster doctor dispatch effectively improved survival rates. An algorithm was developed to assess trauma severity (severity probability) based on accident information. DCN dispatches doctors based on information, including accident site and severity probability, that is sent to smartphones of doctors, reducing the time from accident to DH request by approximately 17 min.DCN is the world's first system for faster doctor dispatch to traffic accident sites based on automotive engineering information. It is crucial for improving survival rates and mitigating aftereffects.

著者

Shuji Matsumoto

出版者

The Medical Association of Nippon Medical School

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.85, no.4, pp.196-203, 2018-08-15 (Released:2018-09-27)

参考文献数

54

被引用文献数

37

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Balneotherapy is a treatment with healing waters, which includes bathing and physiotherapy in thermal water, therapeutic drinks, medical massage, and water jet massage. It is based on the buoyancy, physical properties, temperature, and chemical effects of mineral water. Throughout European and Japanese medical institutions, balneology and hot spring therapy is very much a part of routine medical treatment. The mechanism of balneotherapy is not yet completely understood. Balneotherapeutic procedures are mainly performed for the prevention, treatment, and rehabilitation of musculoskeletal diseases, but they have also proven useful for various other indications such as for the treatment or rehabilitation of dermatological diseases, immuno-inflammatory diseases, chronic pain syndromes, chronic cardiac diseases, and metabolic syndromes or neurological diseases as well as in the rehabilitation of patients with psychiatric conditions. Balneotherapy works well in the case of muscle tension, as it is relieving and relaxing, and it may be associated with improvement of various diseases. However, further investigations are necessary to determine the effectiveness, safety, standard procedures, and potential side effects of balneotherapy.

著者

Yuri Kinoshita Hidehisa Saeki

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.84, no.3, pp.110-117, 2017-06-15 (Released:2017-07-19)

参考文献数

43

被引用文献数

9

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Toxic epidermal necrolysis (TEN) is a severe adverse drug reaction associated with the separation of skin and mucous membranes at the dermal-epidermal junction. Although it is rare, many treatments have been trialed because of its high mortality rate. Active interventions performed to date include the use of systemic corticosteroids, intravenous immunoglobulins (IVIg), cyclosporine, plasmapheresis, anti-tumor necrosis factor drugs and N-acetylcysteine, but none has been established as the most effective therapy. IVIg and short-term high-dose corticosteroids were regarded as the most promising treatments for TEN in a comprehensive review of all reported TEN cases from 1975-2003. When used with an appropriate dose and timing, the beneficial effects of IVIg can be maximized. Although no randomized controlled trials have been conducted, cyclosporine and plasmapheresis are considered to be beneficial. As no gold standard for active intervention for TEN has been established, the choice of treatment relies partly on the available guidelines and the experience of the dermatologist. There is still much to be investigated regarding the pathogenesis of TEN, and new findings may contribute to the identification of an effective active intervention strategy.

著者

Takashi Ueno Tokuya Omi Eiji Uchida Hiroyuki Yokota Seiji Kawana

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.81, no.1, pp.4-11, 2014 (Released:2014-03-10)

参考文献数

23

被引用文献数

7 20

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Background: Treating chronic wounds is challenging. Despite standard wound care, some chronic wounds fail to heal. Therefore, hyperbaric oxygen therapy (HBOT) was developed as an adjunct to standard wound care. Objective: To evaluate the efficacy of HBOT for treating chronic wounds due to a variety of causes at our institution. Methods: We reviewed the medical records of patients with chronic wounds treated with HBOT in addition to standard wound care at the Department of Dermatology, Nippon Medical School Hospital, from 2009 through 2012. Twenty-nine patients were reviewed (14 men and 15 women; mean age, 64.1±14.4 years). The cause of chronic wounds was diabetes mellitus (DM) in 13 patients, venous stasis in 10, polyarteritis nodosa cutanea in 2, and livedoid vasculopathy, pyoderma gangrenosum, chronic renal failure, and systemic sclerosis in 1 patient each. The patients underwent HBOT for 60 minutes with 100% oxygen delivered via a mask in a hyperbaric chamber pressurized to 2.8 atmospheres of absolute pressure. The response of the chronic wounds to HBOT was evaluated according to the following criteria: "excellent": more than 90% wound healing; "good": a greater than 30% reduction in wound size, and wound healing was confirmed on follow-up visits within 6 weeks; "fair": wound healing was achieved with a combination of further invasive interventions; and "poor": the wound showed a less than 30% reducion or worsened during HBOT, or wound healing had not been completed by follow-up visits within 6 weeks. Results: The response to HBOT was "excellent" in 6 patients, "good" in 8, "fair" in 11, and "poor" in 4. All 4 patients with a "poor" response had DM and had undergone hemodialysis. Conclusions: HBOT is an effective treatment for patients with chronic wounds, due to a variety of causes, when used in combination with conventional standard therapy or further interventions. However, HBOT is less effective in patients with DM than in patients with venous stasis because hemodialysis, which is more common in patients with DM, has negative effects on wound healing.

著者

高橋 秀実

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.69, no.5, pp.410-414, 2002 (Released:2002-10-25)

参考文献数

19

被引用文献数

1

著者

千葉 隆 福永 慶隆

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.68, no.1, pp.78-80, 2001 (Released:2001-11-30)

参考文献数

3

著者

Susumu Okada Yoshiharu Ohaki Kohei Inoue Takashi Kawamura Toshihiko Hayashi Tomoyasu Kato Tatsuo Kumazaki

出版者

The Medical Association of Nippon Medical School

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.72, no.1, pp.29-33, 2005 (Released:2005-04-15)

参考文献数

7

被引用文献数

20 30

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Mucinous cystic ovarian tumors sometimes contain calcifications, but the frequency and significance of such calcifications in diagnostic radiology are not well understood. We therefore retrospectively investigated the radiological and histopathological evidence of calcifications in 44 cases of ovarian mucinous cystic tumors (22 benign, 13 borderline, and 9 malignant) and 21 cases of ovarian serous cystic tumors (6 benign and 15 malignant) in which a non-contrast CT scan was performed. The shape and distribution of the calcifications in the mass lesion were assessed both radiologically and histopathologically.Calcifications were noted in 34.1% of mucinous cystic tumors on CT scans and 56.8% in histopathological studies, and they were found in two locations, intramural and intra-cystic, according to the histopathological findings. Intramural calcifications were frequent in benign tumors, and intra-cystic calcifications were frequent in proliferating tumors. Calcifications (psammoma bodies) were noted in 4.7% of serous cystic tumors on CT scans and 14.3% in histopathological studies. CT was not sufficiently sensitive in the detection of intra-cystic calcification in mucinous tumors and psammoma bodies in serous tumors. However, the presence of intramural calcifications may be a good indicator of mucinous tumors. Understanding the frequency and morphology of the calcifications in these neoplasms is one of the keys to making a correct diagnosis.

著者

Marie Ito Kayoko Terada Zuisei Hayashi Shunji Suzuki

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.81, no.4, pp.289-291, 2014 (Released:2014-09-03)

参考文献数

6

被引用文献数

2

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We examined differences in delivery modes between deliveries managed by female obstetricians and gynecologists (OB/GYNs) and those managed by male OB/GYNs at our hospital. The rate of vacuum extraction/forceps delivery was significantly lower when deliveries were managed by female OB/GYNs. Logistic regression analysis showed that the lower rate of vacuum extraction/forceps delivery was associated with a lower rate of diagnosis of nonreassuring fetal status during the second stage of labor by female OB/GYNs. The rate of cesarean delivery and obstetric outcomes did not differ with the gender of the managing OB/GYN. The increasing number of female OB/GYNs may help increase the rate of maternal satisfaction associated with the decreased rate of instrumental delivery.

著者

Sakae Kumasaka Atsushi Takagi Kentaro Kuwabara Makoto Migita

出版者

日本医科大学医学会

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.80, no.6, pp.456-459, 2013 (Released:2014-01-10)

参考文献数

6

被引用文献数

1

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A case of herpes simplex virus (HSV) encephalitis in a neonate after delivery from a woman whose genital HSV infection had been treated with acyclovir is reported. The main approach to prevent genital HSV infection in the neonate is interruption of transmission at the time of delivery. Guidelines for prophylactic therapy with acyclovir have been established, but the risk of neonatal infection remains. A fever began to develop in a male neonate delivered vaginally from a 35-year-old woman. Treatment with intravenous acyclovir was started on the basis of a diagnosis of HSV encephalitis, because polymerase chain reaction was positive for HSV in the cerebrospinal fluid. The mother had had a first genital HSV infection during the second trimester, but treatment with injected acyclovir had caused the blisters and erosion to resolve by the time of delivery. Important steps for preventing neonatal HSV infection are the appropriate treatment of mothers with a history of genital HSV infection, the assessment of delivery methods, and the appropriate treatment of neonates.