著者

本田 光芳

出版者

日本医科大学医学会

雑誌

日本医科大学雑誌 (ISSN:00480444)

巻号頁・発行日

vol.51, no.5, pp.539-543, 1984-10-15 (Released:2009-07-10)

参考文献数

22

著者

杉本 元祐

出版者

日本医科大学医学会

雑誌

日本医科大学雑誌 (ISSN:00480444)

巻号頁・発行日

vol.28, no.6-8, pp.1342-1355, 1961-12-15 (Released:2010-12-22)

参考文献数

57

著者

金涌 佳雅

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.14, no.3, pp.100-112, 2018-06-15 (Released:2018-08-08)

参考文献数

49

被引用文献数

4

---

Koritsu-shi (solitary death) refers to cases of death in which the deceased was living in a one-person household. In Japan, koritsu-shi cases have received significant attention as a major social problem because the aging population has led to an increase in single-person households. However, because the definition of koritsu-shi is unclear and carrying out a national level survey of households where the occupant has died is difficult, the actual situation surrounding koritsu-shi has not been elucidated. As koritsu-shi is legally treated as an unnatural death, statistics on koritsu-shi have been reported in many areas (Tokyo, Osaka, Kobe) under the medical examiner system. Of these areas, statistics from the Tokyo ward area have revealed the most information and show that the proportion of unnatural deaths involving koritsu-shi has been increasing year after year, with 36% of cases being koritsu-shi in 2016. Each year showed that koritsu-shi was higher in men than women. Although the deceased were predominantly male in cases of middle-aged koritsu-shi, both sexes are affected more evenly in single-elderly cases. However, the overall incidence was higher in men when the numbers of middle aged and elderly people are tallied against the higher numbers of elderly women. In men, the characteristic cause of death is chronic alcoholic liver injury with other cases mostly being categorized as unknown due to postmortem damage. Even within the densely populated Tokyo ward area, spatial clustering was detected with regard to the incidence of koritsu-shi per ward. There are many points that are consistent between reports of koritsu-shi in the Tokyo ward area and other areas. However, it is not easy to compare results among different regions due to the unclear definition of koritsu-shi and insufficient bias exclusion. Koritsu-shi cases are expected to increase in Japan in the future. Future efforts should focus on finding the deceased as soon as possible after death, or even pursuing the possibility of preventing koritsu-shi in cases when an individual living in a one-person household suddenly collapses at home. In addition, to reduce the effect of loneliness and social isolation among those living in single-person households to improve health outcomes, it is important that medicine and public health efforts address the problem of koritsu-shi.

著者

富山 俊一

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.3, pp.212-218, 2003 (Released:2003-06-25)

参考文献数

49

被引用文献数

2 2

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Since the report of Duke in which an allergic etiology was considered to be the cause of Meniere's disease, the hypothesis that a certain type of Meniere's disease is generated through immuno-pathological mechanisms has been advocated for 70 years. During this period, another entity of immune-mediated inner ear disorders, i. e., autoimmune inner ear disease was introduced. Fundamental immunological phenomena of the inner ear have been rapidly elucidated since 1980. The endolymphatic sac is the only site which contains immuno-competent cells within the inner ear. The inner ear is capable of mounting active immune responses when appropriately stimulated and the endolymphatic sac plays an integral function for inner ear immune response. Acutally, many reports have been published that link immunity and Meniere's disease with a variety of proposed immune-related etiologies from autoimmunity to non-autoimmunity. It is suggested that immune injury to the endolymphatic sac plays an important role in the pathogenesis of Meniere's disease. These functional and morphological circumstances strongly suggest that an immunological etiology of Meniere's disease is not theoretically unfounded.

著者

中村 祐久

出版者

日本医科大学医学会

雑誌

日本医科大学雑誌 (ISSN:00480444)

巻号頁・発行日

vol.33, no.1, pp.33-46_2, 1966-02-15 (Released:2010-10-14)

参考文献数

46

著者

Takashi Araki Masato Miyauchi Makoto Suzaki Taro Wakakuri Sonoko Kirinoki Naoko Onodera Taro Saigusa Akihiro Takana Hideya Hyodo Toshihiko Ohara Makoto Kawai Masahiro Yasutake Hiroyuki Yokota

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.82, no.6, pp.295-299, 2015-12-15 (Released:2016-01-27)

参考文献数

10

被引用文献数

1

---

Objective: Current data indicate that the rate of trauma in children during gymnastic formation is increasing, especially while creating a structure with a certain height, such as the human pyramid. The goal of the present study was to clarify the clinical characteristics of these injuries. Methods: In this single-institution review, all children treated for a gymnastic formation-related injury at Nippon Medical School Hospital from 2013 through 2015 were identified through the institution's registry. The injury mechanism was classified, and injury severity, interventions, and outcome were examined. Results: Eight children were treated for a gymnastic formation-related injury. They were 7 boys and 1 girl aged 10 to 15 years (mean age, 13.1±1.8 years). Neurotrauma ranging from concussion to spinal cord injury without radiographic abnormality occurred in 6 patients (75%). No intracranial hemorrhagic lesions were detected. The Glasgow Coma Scale score on arrival was 15 in all 8 patients, and neurological deficits were present in 1 patient. No patient required surgical intervention. All patients made a full recovery after discharge from the hospital. No patients died. The average follow-up period was 2.1±0.9 weeks. Conclusions: Neurotrauma is a frequent result of gymnastic formation accidents in children. Healthcare workers and teachers should recognize this type of injury, and public education that targets parents should be introduced.

著者

柴田 正義

出版者

日本医科大学医学会

雑誌

日本医科大学雑誌 (ISSN:00480444)

巻号頁・発行日

vol.39, no.1, pp.36-48, 1972-01-15 (Released:2010-10-14)

参考文献数

26

著者

小泉 功

出版者

日本医科大学医学会

雑誌

日本医科大学雑誌 (ISSN:00480444)

巻号頁・発行日

vol.20, no.3, pp.234-243, 1953 (Released:2010-10-14)

被引用文献数

1 1

著者

清水 一雄

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.10, no.2, pp.90-100, 2014 (Released:2014-05-08)

著者

蓑茂 上

出版者

日本医科大学医学会

雑誌

日本医科大学雑誌 (ISSN:00480444)

巻号頁・発行日

vol.24, no.11, pp.864-866, 1957-11-15 (Released:2009-07-10)

参考文献数

5

著者

白倉 毅

出版者

日本医科大学医学会

雑誌

日本医科大学雑誌 (ISSN:00480444)

巻号頁・発行日

vol.27, no.6, pp.1041-1053, 1960-06-15 (Released:2010-10-14)

参考文献数

45

著者

松下 道雄

出版者

日本医科大学医学会

雑誌

日本医科大学雑誌 (ISSN:00480444)

巻号頁・発行日

vol.40, no.3, pp.163-168_3, 1973-04-15 (Released:2010-10-14)

参考文献数

36

著者

Hisashi Matsumoto Kunihiro Mashiko Yuichiro Sakamoto Noriyoshi Kutsukata Yoshiaki Hara Hiroyuki Yokota

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.77, no.1, pp.13-20, 2010 (Released:2010-02-15)

参考文献数

21

被引用文献数

7 17

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Background: Several reports have validated the criteria for damage control surgery (DCS). However, although metabolic acidosis and body temperature can be measured quickly, tests for predicting the severity of coagulopathy require special laboratory equipment and take 15 to 30 minutes. Such delays could be life-threatening for patients requiring DCS. The aim of this study was to establish simplified and practical criteria to enable rapid decision-making regarding the need for DCS. Methods: Thirty-four consecutive patients with unstable hemodynamics after initial fluid resuscitation who had undergone DCS for severe abdominal or pelvic injuries were retrospectively analyzed. The patients' characteristics, clinical courses, laboratory data, and outcomes were reviewed using the data contained in their medical records. Results: The overall survival rate was 55.9% (survivors group: n=19; nonsurvivors group: n=15), which was similar to the calculated mean probability of survival (Ps=0.5671). At the start of surgery, the systolic blood pressure (SBP) was less than 90 mm Hg in all cases in which surgery failed, and the mean SBP in the nonsurvivors group (69.6 ± 14.8 mm Hg) was significantly lower than that in the survivors group (93.2 ± 22.9 mm Hg, p=0.006). Except in two cases, the value of the base excess in the nonsurvivors group was less than -7.5 mmol/L, and the mean base excess (-11.5 ± 5.3 mmol/L) in the nonsurvivors group was significantly less than that in the survivors group (-5.5 ± 4.9 mmol/L, p=0.008) at the start of surgery. The core temperature at the start of surgery was less than 35.5°C in all cases in the nonsurvivors group. On the basis of these results, three indicators (SBP less than 90 mm Hg, base excess less than -7.5 mmol/L, and core temperature less than 35.5°C at the start of surgery) were identified. The success rate of DCS in patients who possessed all three indicators (28.6% ) was significantly lower than that in patients who did not possess all three indicators (75.0%; p=0.014). Conclusion: Our results indicate that surgeons should decide to perform DCS when only one or two criteria defined in this study are met and should not wait for all three criteria. Although our proposed criteria are not strict and may broaden the indications for DCS, leading to an increase in the number of DCS procedures, saving the lives of patients who have sustained severe torso trauma must be the priority; 'over-triage' may be acceptable in situations where an appropriate decision-making protocol has been followed.

著者

Daishu Miura Kimiyasu Yoneyama Yoshiaki Furuhata Kazuo Shimizu

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.211-220, 2014 (Released:2014-09-03)

参考文献数

26

被引用文献数

5 18

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Introduction: An important mechanism by which trastuzumab inhibits the growth of human epidermal growth factor receptor 2 (HER2)-positive breast cancer cells is the activation of a host tumor response via antibody-dependent cell-mediated cytotoxicity (ADCC). Although paclitaxel has a synergistic effect in combination with trastuzumab, whether ADCC is enhanced by paclitaxel is not known. In the present study we examined whether adding paclitaxel to trastuzumab enhances ADCC and also investigated the kinetics of effector cells in ADCC. Materials and Methods: The subjects were 20 patients with HER2-positive breast cancer: 9 received the combination of trastuzumab (4 mg/kg as a loading dose and 2 mg/kg weekly) and paclitaxel (80 mg/m2 weekly) and 19 received monotherapy with trastuzumab. In blood samples (mononuclear cells) obtained before and 10 minutes after administration of chemotherapy, ADCC and the number of effector cells, including natural killer (NK) cells, monocytes, and CD64+ cells, were compared in each case. The ADCC was analyzed with a 51Cr releasing assay using the SK-BR-3 cell line, and the fractions of NK cells (both CD16+ [FcγRIII] and CD56+) and CD64+ (FcγRI) cells were analyzed with flow cytometry. Results: The mean ADCC level increased 20% after trastuzumab monotherapy and 126% (p<0.05) after combination therapy with trastuzumab and paclitaxel. All 9 patients receiving combination therapy had increased ADCC levels. The number of NK cells increased 51% after trastuzumab monotherapy and 112% (p<0.05) after combination therapy. No significant changes were found in monocytes (39% increase) or CD64+ cells (53% increase) after trastuzumab monotherapy, but monocytes decreased 40% (p<0.05) and CD64+ cells decreased 24% after combination therapy. Conclusions: Adding paclitaxel to trastuzumab significantly enhances ADCC, with levels twice as great as with trastuzumab monotherapy, through a rapid recruitment of NK cells. This finding suggests that the combination of trastuzumab and paclitaxel has a stronger-than-expected synergistic effect in HER2-positive breast cancer.

著者

戸田 茂樹 喜多村 孝幸

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.3, no.1, pp.44-45, 2007 (Released:2007-03-23)

参考文献数

5

著者

Gen Horiguchi Takafumi Aoki Hiromoto Ito

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.78, no.4, pp.208-213, 2011 (Released:2011-08-26)

参考文献数

16

被引用文献数

1

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The main cause of carpal tunnel syndrome (CTS) remains unknown. Stiffness of the subcutaneous area of the volar aspect of the carpal tunnel is present in many patients and suggests that the stiffness of muscles attached to the transverse carpal ligament is increased. We performed an electrophysiological study to investigate muscle activities and to clarify whether the stiffness of muscles attached to the transverse carpal ligament is involved in the pathogenesis of CTS. The subjects of this study included 16 patients with early CTS showing no motor dysfunction. Both thenar muscles (opponens pollicis, abductor pollicis brevis, and flexor pollicis brevis) and hypothenar muscles (opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis) were investigated. Surface electrodes were placed on each muscle, and maximum voluntary contractions with the thumb and little finger in opposition were maintained for 3 seconds in all patients and in 7 control subjects. Electromyographs were subjected to fast Fourier transform analysis, and the root mean square (RMS) and the mean power frequency (MPF) were determined for each muscle. The RMS of the opponens pollicis was significantly less in hands affected by CTS (292.8 μV) than in healthy hands (405.9 μV). The RMS did not differ between affected hands and healthy hands for the other 2 thenar muscles but did differ significantly for the hypothenar muscles. The MPF did not differ between affected hands and healthy hands for any muscle. The results show that electrophysiological differences are present among muscles innervated by the median nerve and that hypothenar muscles originally unrelated to median nerve dysfunction are also affected in early CTS. These results suggest that modulation of muscles attached to the transverse carpal ligament is involved in the pathogenesis of CTS.

著者

Ken Okamoto Takeshi Nishino

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.75, no.1, pp.2-3, 2008 (Released:2008-03-21)

参考文献数

4

被引用文献数

8 20

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Xanthine oxidoreductase (XOR) catalyzes the reaction of hypoxanthine to xanthine and of xanthine to uric acid. Inhibitors of XOR can thus decrease the concentration of uric acid in serum. Crystal structures of XOR bound with various inhibitors reveal that inhibitors can be categorized into three types, i.e. mechanism-based, structure-based, and hybrid types.

著者

木村 真人

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.1, no.1, pp.12-16, 2005 (Released:2005-06-24)

参考文献数

18

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The association between cerebrovascular diseases and depression has been recognized for many years. Studies have found much information about the pathogenesis and treatment of post-stroke depression in the West since the 1970s. On the other hand, the concept of vascular depression was introduced in 1997, as the prevalence of silent cerebral infarctions detected by MRI scans in patients with late-onset depression is higher than that in non-depressed patients. This paper gives an outline of the clinical findings about vascular depression including post-stroke depression.

著者

角田 陽平 大角 真 鈴木 俊治

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.19, no.1, pp.10-14, 2023-02-20 (Released:2023-03-11)

参考文献数

12

著者

横堀 將司 藤倉 輝道

出版者

日本医科大学医学会

雑誌

日本医科大学医学会雑誌 (ISSN:13498975)

巻号頁・発行日

vol.18, no.2, pp.129-134, 2022-04-25 (Released:2022-05-12)

参考文献数

3

被引用文献数

1