著者
田中 敏秀 宮本 俊明
出版者
一般社団法人 日本臨床リウマチ学会
雑誌
臨床リウマチ (ISSN:09148760)
巻号頁・発行日
vol.21, no.3, pp.273-278, 2009-09-30 (Released:2016-03-31)
参考文献数
6

The patient was an18-year-old female who first showed high CPK levels in August 2000 (when she was 12years old). Muscle biopsy confirmed dermatomyositis. Together with skin rash, she was diagnosed with juvenile dermatomyositis. She was treated with oral prednisolone (PSL) at a daily dose of 60 mg (≒2 mg/kg). Cyclosporine A (140 mg daily) was added for complicating interstitial pneumonia. However, her disease frequently relapsed when she had the common cold or other triggering factors. Various second-line treatments, such as intravenous immunoglobulin (IVIg) (45 g; 2 sessions), monthly IVCY (700 mg/body; 22 sessions), pulse methylprednisolone (1 g; 9 sessions), azathioprine (AZP, 50 mg daily), methotrexate (MTX, 16 mg weekly) and mycophenolate mofetil (3 g daily), were attempted for relapses. However, her flare never placed under good control. On the first visit to our clinic at the age of 18 years (February 2007), she showed a significantly increased level of serum CPK. Despite the combination of oral PSL (20 mg daily), AZP (150 mg daily) and MTX (16 mg weekly), her CPK reached8, 154 IU/L. Thus, AZP and MTX were substituted with tacrolimus (TAC), which had never been used, and pulse therapy with methylprednisolone (m-PSL) followed by oral m-PSL (48 mg daily). Her serum levels of myogenic enzymes were normalized after this treatment and no relapse has been observed for a year.    Recently, there have been domestic and overseas studies describing the effectiveness of TAC on myositis. This is another case demonstrating the efficacy of the combination therapy of steroid hormone and TAC on dermatomyositis resistant to various immunosuppressants.
著者
赤川 力
出版者
日本箱庭療法学会
雑誌
箱庭療法学研究 (ISSN:09163662)
巻号頁・発行日
vol.26, no.2, pp.41-50, 2013 (Released:2014-01-24)
参考文献数
11

本稿は,下着の窃盗をした不登校の中学2年男子生徒との事例研究である。このクライエントは児童相談所から児童自立支援施設に処置され,その後にスクールカウンセラーに依頼された事例であった。面接開始時は訪問面接であったが,最後には学校での面接に至った。このクライエントは,主に音楽のイメージを用いて表現してきた。考察では,3点について考察した。1.音楽を通して表現されたもの,2.通路としての音楽と「橋をかける」機能としての音楽について,3.ClとThとの関係性について,である。
著者
Akinori Hayashi Koji Takano Sayuki Kawai Masayoshi Shichiri
出版者
(社)日本内分泌学会
雑誌
Endocrine Journal (ISSN:09188959)
巻号頁・発行日
vol.63, no.2, pp.187-191, 2016 (Released:2016-02-29)
参考文献数
9
被引用文献数
2 10

Diabetes mellitus complicated with insulin antibodies is rare in clinical practice but usually difficult to control. A high amount of insulin antibodies, especially with low affinity and high binding capacity, leads to unstable glycemic control characterized by hyperglycemia unresponsive to large volume of insulin and unanticipated hypoglycemia. There are several treatment options, such as changing insulin preparation, immunosupression with glucocorticoids, and plasmapheresis, most of which are of limited efficacy. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of drug which decrease renal glucose reabsorption and lowers plasma glucose level independent of insulin action. We report here a case with diabetes complicated with insulin antibodies who was effectively controlled by an SGLT2 inhibitor. A 47-year-old man with type 2 diabetes treated with insulin had very poor glycemic control characterized by postprandial hyperglycemia unresponsive to insulin therapy and repetitive hypoglycemia due to insulin antibodies. Treatment with ipragliflozin, an SGLT2 inhibitor, improved HbA1c from 8.4% to 6.0% and glycated albumin from 29.4% to 17.9%. Continuous glucose monitoring revealed improvement of glycemic profile (average glucose level from 212 mg/dL to 99 mg/dL and glycemic standard deviation from 92 mg/dL to 14 mg/dL) with disappearance of hypoglycemic events. This treatment further ameliorated the characteristics of insulin antibodies and resulted in reduced insulin requirement. SGLT2 inhibitors may offer an effective treatment option for managing the poor glycemic control in diabetes complicated with insulin antibodies.
著者
Yumiko Komatsu Akinobu Nakamura Masahiro Takihata Yuichiro Inoue Satoko Yahagi Kazuki Tajima Hirohisa Tsuchiya Tatsuro Takano Tadashi Yamakawa Masahiro Yoshida Hideaki Miyoshi Yasuo Terauchi
出版者
(社)日本内分泌学会
雑誌
Endocrine Journal (ISSN:09188959)
巻号頁・発行日
vol.63, no.3, pp.311-314, 2016 (Released:2016-03-31)
参考文献数
11
被引用文献数
2 14

Diazoxide is a non-diuretic benzothiadiazine derivative, one of a group of substances introduced into clinical practice in the 1950s for the treatment of hypertension. Fajans reported the use of diazoxide for the treatment of insulinoma in 1979. Although patients with hyperinsulinemic hypoglycemia worldwide have been treated with diazoxide for more than 30 years, there are no recent reports about the adverse effects of this drug in Asian patients, including Japanese patients. Herein, we report the results of our retrospective clinical record review of 6 Japanese patients (3 females and 3 males, ranging in age from 58 to 91 years) with hyperinsulinemic hypoglycemia and inoperable insulinoma treated with diazoxide. Diazoxide improved control of hypoglycemic symptoms and maintained normoglycemia in 5 of the 6 patients, and was ineffective in one patient. Surprisingly, although all 6 patients received diazoxide according to the treatment strategy recommended in Western patients, 5 of the 6 patients developed edema and two developed congestive heart failure. Thus, when starting treatment with diazoxide in Japanese patients, the symptoms and signs of fluid retention should be evaluated carefully. Also, appropriate protocols for treatment with diazoxide should be evaluated by means of clinical trials in Japanese patients with hyperinsulinemic hypoglycemia.
著者
白崎 博公
出版者
公益社団法人 精密工学会
雑誌
精密工学会誌 (ISSN:09120289)
巻号頁・発行日
vol.78, no.2, pp.127-131, 2012-02-05 (Released:2012-08-05)
参考文献数
12
著者
Marco Matteo Ciccone Maria Felicia Faienza Maria Altomare Carmela Nacci Monica Montagnani Valente Federica Francesca Cortese Michele Gesualdo Annapaola Zito Rossana Mancarella Domenico Leogrande Domenico Viola Pietro Scicchitano Paola Giordano
出版者
一般社団法人 日本動脈硬化学会
雑誌
Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日
pp.31740, (Released:2016-02-22)
参考文献数
53
被引用文献数
1 26

Aim: Although the underlined mechanisms are still unknown, metabolic/coagulation alterations related to childhood obesity can induce vascular impairments. The aim of this study was to investigate the relationship between metabolic/coagulation parameters and endothelial function/vascular morphology in overweight/obese children.Methods: Thirty-five obese/overweight children (22 pre-pubertal, mean age: 9.52±3.35 years) were enrolled. Body mass index (BMI), homeostasis model assessment index (HOMAIR), metabolic and coagulation parameters, [adiponectin, fibrinogen, high molecular weight adiponectin (HMW), endothelin-1, and vonWillebrand factor antigen] ultrasound early markers of atherosclerosis [flow-mediated dilatation (FMD), common carotid intima-media thickness (C-IMT), and anteroposterior diameter of infra-renal abdominal aorta (APAO)] were assessed.Results: APAO was related to anthropometric (age: r=0.520, p=0.001; height: r=0.679, p<0.001; weight: r=0.548, p=0.001; BMI: r=0.607, p<0.001; SBP: r=0.377, p=0.026) and metabolic (HOMAIR: r=0.357, p=0.035; HMW: r=-0.355, p=0.036) parameters. Age, height, and systolic blood pressure were positively related to increased C-IMT (r=0.352, p=0.038; r=0.356, p=0.036; r=0.346, p=0.042, respectively). FMD was not related to any clinical and biochemical characteristics of the pediatric population. Age, HOMAIR, fasting glucose levels, and HMW were independent predictors for APAO increase. Each unit decrease in HMW concentrations (1 μg/ml) induced a 0.065 mm increase in APAO.Conclusion: High molecular weight adiponectin is related to cardiovascular risk in overweight/obese children.

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出版者
国立研究開発法人 科学技術振興機構
雑誌
情報管理 (ISSN:00217298)
巻号頁・発行日
vol.59, no.1, pp.71-71, 2016-04-01 (Released:2016-04-01)
著者
内田 順子
出版者
日本社会学会
雑誌
社会学評論 (ISSN:00215414)
巻号頁・発行日
vol.65, no.4, pp.504-520, 2015 (Released:2016-03-31)
参考文献数
23

本稿は, 国立歴史民俗博物館が実施している民俗研究のための映像制作を事例として, 「映像を保存・活用する」際の諸課題について考察するものである. 長期的な展望をもって映像を制作し, 保存し, 活用するには, メディア変換などの技術的な問題, 著作権・肖像権などの法的問題, アーカイブの構築などの映像を共有するしくみに関する問題などを解決していく必要がある. 民俗研究を目的として制作された映像は, 研究者と, 研究対象となる地域の人びととの協働によってつくられるものであるため, その協働の関係性は, 映像そのものに色濃く反映される. そのような映像を保存・活用する際には, 著作権・肖像権に関する一般的な検討とは別に, 倫理的な問題として検討しなければならない事柄がある. その点が, 一般的な映像の保存・活用と異なるところである.