Author Irie, Seiji|
Published Date 1983-08-31
Publication Title 岡山医学会雑誌
Volume volume95
Issue issue7-8
Content Type Journal Article
Author Irie, Seiji|
Published Date 1983-08-31
Publication Title 岡山医学会雑誌
Volume volume95
Issue issue7-8
Content Type Journal Article
JaLCDOI 10.18926/21107
Title Alternative An evaluation of pancreatographic findings in the differential diagnosis of chronic pancreatitis and pancreatic cancer
FullText URL pitsr_054_039_041.pdf
Author Tanaka, Juntaro| Ochi, Koji| Irie, Seiji| Takeda, Masahiko| Harada, Hideo|
Abstract In an attempt to evaluate the pancreatographic findings, particularly of the pancreatic duct branches, in the differrential diagnosis of chronic pancreatitis and Pancreatic cancer, twenty seven post mortem pancreases were subjected to retrograde pancreatography and histological examination. The materials consist of 15 cases with chronic pancreatitis and 12 cases with pancreatic cancer. The results obtained are as follows. 1) In cases with chronic pancreatitis, abnormal findindings such as irregular dilatation, straightening-hardening, narrowing-stenosis of the pancreatic duct branches were more common. 2) Incases with pancreatic cancer, abnormal findings such as diminishing, irregular dilatation, narrowing-stenosis of the pancreatic duct branches were more common. 3) Abnormal findings in cases with chronic pancreatitis reveled the dendency of diffuse expansion, on the other hand, in case with pancreatic cancer revealed the tendency of localized expansion. 4) When the fine and clear pancreatography was obtained, it was possible to predict the presence of chronic inflammation or tumor cell infiltration from above findings and tendencies. On the contrary, in cases with localized, severe chronic pancreatitis and in cases with complicated, it was difficult to differentiate the pancreatic cancer from chronic pancreatitis.
Publication Title 岡山大学温泉研究所報告
Published Date 1984-03-25
Volume volume54
Start Page 39
End Page 41
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310981
JaLCDOI 10.18926/21105
Title Alternative A case report of a family with Peutz-Jeghers syndrome
FullText URL pitsr_054_025_033.pdf
Author Irie, Seiji| Harada, Hideo| Kawabata, Kenji| Shibata, Tsuneo|
Abstract A 58-year-old female was admitted because of colicky abdominal pain. Physical examination revealed firm abdominal wall, increased bowel sounds and multiple pigmented macules on the lips, oral mucosa, soles and volar aspects of the fingers and toes. Hyperventilation and tetanic rigidity of the extremities were also noted. The symptoms were successfully treated by intravenous injection of butropium bromide and diazepam. Roentgenological and fiberscopic examination revealed multiple polyps in the stomach, small intestine and colon ; the small intestine was most heavily loaded with polyps. Biopsy specimen revealed only inflammatory changes. The patient had undergone a resectien of the terminal ileum with polyps 15 years previously because of ileo-ileal intussusception. Histological re-evaluation of the polyp showed an actively proliferating papillary adenoma. The characteristic history and gastrointestinal findings lead us to the examination of the family, which revealed that her father, son and grandson had similar pigmentation of the skin and polyps in the gastrointestinal tract. These characteristic findings and family history permitted us to make a diagnosis of Peutz-Jeghers syndrome. The diagnosis had been missed supposedly because of unawareness of the skin lesions and the lack of hamartoma-like findings in the polyp. The tetanic rigidity of the extremities was probably hyperventilation syndrome induced by severe abdominal pain. The patient has been followed up for possible recurrence of symptoms and a potential malignant change.
Publication Title 岡山大学温泉研究所報告
Published Date 1984-03-25
Volume volume54
Start Page 25
End Page 33
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310995
JaLCDOI 10.18926/19706
Title Alternative Short term effect of spa-water on gastric mucosal blood flow
FullText URL 058_001_004.pdf
Author Tanaka, Juntarou| Matumoto, Shuuji| Senou, Toshinobu| Irie, Seiji| Ochi, Kouji| Takeda, Masahiko| Harada, Hideo|
Abstract 臓器反射スペクトル法と内視鏡を併用して胃粘膜血流を測定し,当院温泉水飲用の消化機能に対する基礎的検討を胃粘膜血流を指標に行なった。温泉水の対照として空気と白湯を選び3群に分け検討した。その結果,温泉水は空気に比し胃粘膜血流を増加させる作用を有していることが示唆された。また温泉水は部分的ではあるが白湯にくらべても胃粘膜血流を増加させる作用があることが示唆された。よって飲泉療法の消化器疾患に対する臨床的有用性が胃粘膜血流の面からもうかがわれた。
Abstract Alternative Short-term effects of spa-drink therapy on gastric mucosal blood flow were evaluated by an endoscopic organ reflex spectrophotometry, using Olympus XQ-10. Thirty-four subjects were randomly divided into three groups : 10 subjects for warm spa-water (40±C) infusion group, 10 subjects for warm tap-water infusion group, and 14 subjects for warm air infusion group. Intragastric infusion of water or air was performed through the fiberscopic infusion channel. Gastric mucosal blood flow was determined just before and 10 min after the infusion on the three points of gastric mucosa : lesser curvature of the angle, the antrum and the pylorus. Following results were obtained : 1) Spa-water exerted a beneficial effect on gastric mucosal blood flow as compared to air. The difference was statistically significant on all of the three points. 2) Spa-water tended to exert a beneficial effect on gastric mucosal blood flow as compared to tap-water. The difference, however, was significant only on the mucosa of the gastric antrum. In conclusion, it was suggested that spa-drink therapy was useful for the treatment of chronic gastritis and gastric ulcer in which impairment of gastric mucosal blood flow plays an important pathogenetic role. Studies on the long-term effects of spa-drink therapy on the gastric mucosal blood flow are now in progress.
Keywords 飲泉療法 (Spa-drink therapy) 消化器機能 (Digestive function) 胃粘膜血流 (Gastric mucosal blood flow) 臓器反射スペクトル法 (Organ reflex spectrophotometry)
Publication Title 環境病態研報告
Published Date 1987-08
Volume volume58
Start Page 1
End Page 4
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309081
JaLCDOI 10.18926/19715
Title Alternative Effect of spa-drink therapy on exocrine pancreatic function
FullText URL 058_012_016.pdf
Author Matsumoto, Shuji| Harada, Hideo| Ochi, Koji| Takeda, Masahiko| Tanaka, Juntaro| Senou, Toshinobu| Irie, Seiji| Ishibashi, Tadaaki| Kimura, Ikuro|
Abstract 膵外分泌機能におよぼす飲泉(三朝温泉水)の効果を飲泉群および非飲泉群を対象として検討した。膵外分泌機能検査法としては,糞便中キモトリプシン活性比色測定法(モノテストカイモトリプシン)を用いた。その結果,糞便中キモトリプシン活性は,飲泉開始2週後に40 % の患者で上昇し,4週後は2週後と変わらなかった。以上より,2週間の飲泉は膵外分泌機能を改善させる効果があることがわかった。
Abstract Alternative The effect of spa-drink therapy (Misasa hot spring) on exocrine pancreatic function was studied on 18 patients after their physical and psychological conditions were stabilized about two weeks following hospitalization. Patients were randomly divided into two groups : eight patients into a control group (continuance of spa-bathing) and 10 patients into a spa-drink therapy group (continuance of spa-bathing plus commencement of spa-drink therapy). Spa-drink therapy refers to drinking 200mℓ of warm spa-water (42℃) two times a day : between meals in the morning and in the afternoon. Exocrine pancreatic function was evaluated by fecal chymotrypsin activity, using a colorimetric method (Boehringer-Mannheim). Following results were obtained : 1) With 2-week's spa-drink therapy, fecal chymotrypsin activity was significantly enhanced in 40 % of the patients, while none of the controls showed an increase in fecal chymotrypsin activity. 2) Fecal chymotrypsin activity at the time of 4 weeks was similar to that obtained at the time of 2 weeks in both groups. In conclusion, spa-drink therapy for 2 weeks was effective for the enhancement of exocrine pancreatic function.
Keywords 糞便中キモトリプシン活性 (Fecal chymotrypsin activity) 飲泉療法 (Spa-drink therapy) 膵外分泌機能 (Pancreatic exocrine function) 膵 (Pancreas) 酵素 (Enzyme)
Publication Title 環境病態研報告
Published Date 1987-08
Volume volume58
Start Page 12
End Page 16
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309038
JaLCDOI 10.18926/19752
Title Alternative Early diagnosis of pancreatic cancertrial of a mass screening test for detecting early pancreatic cancer
FullText URL 059_024_030.pdf
Author Matsumoto, Shuji| Ochi, Koji| Irie, Seiji| Takeda, Masahiko| Tanaka, Juntaro| Harada, Hideo|
Abstract 膵癌を治癒に導くためには早期診断,早期切除以外に方法はない。そこで,無症状者のなかから早期膵癌を発見するためのスクリーニング法を検討するためProspective studyを実施した。人間ドック目的の来院患者を主とする三朝分院外来患者776名を対象とし,一次スクリーニング検査として,血清アミラーゼ,エラスターゼⅠ,CA19-9,アルカリフォスファターゼ,γ-GTP,血糖値の測定および腹部超音波検査を施行し,異常者に対して二次スクリーニングとして腹部超音波検査の再精査およびERCPを施行した。その結果,早期膵癌1例および進行膵癌2例を検出し,膵癌発見率は0.39% と満足のいく結果が得られた。しかし一次スクリーニング検査の要精検率は46% と高値を示したこと,一次スクリーニング検査の費用は胃集検の約3.3倍,二次スクリーニング検査の費用は胃精査の約2.6倍かかることからcost-benifitの面で問題となった。また見逃し症例の有無をモニターするためfollow upも今後の問題として残った。
Abstract Alternative There is no other way of curing pancreatic cancer than early diagnosis and resection. However, an effective protocol has not been established for detecting early pancreatic cancer among asymptomatic populations by means of a mass screening test. Therefore, a prospective study was attempted on 776 patients who came to Medical Clinic of Misasa Branch Hospital, Okayama University Medical School mostly for a routine annual check-up. The following tentative protocol was proposed, based on the retrospective analyses of our 13 patients with early pancreatic cancer: (1) a first step test includes serum amylase, elastase Ⅰ, alkaline phosphatase, r-GTP, carcinoembryonic antigen, fasting blood sugar and routine abdominal ultrasonography (US); (2) a second step test includes thorough abdominal US with various kinds of probes and patients' positioning which was performed on individuals with abnormal findings on the first step test, (3) a third step test includes ERCP which was performed on individuals with abnormal or questionable findings on the second step test. Further detail examinations were performed when ERCP was abnormal or questionable. Consequently 357 patients (46% of the total 776 patients) underwent thorough US and 45 patients (5.8%) underwent ERCP. ERCP findings included pancreatic cancer in two patients, suspect of pancreatic cancer in three, advanced chronic pancreatitis in two, equivocal as for chronic pancreatitis (according to the Cambridge classification) in nine, and normal in 29. Final diagnosis was early pancreatic cancer in one patient, advanced pancreatic cancer in two, and calcified chronic pancreatitis in two; detection rate of pancreatic cancer (0.39%) in this series was slightly higher than that usually reported with a mass screening test for stomach cancer. From a cost-benefit point of view, however, examinations for the pancreas cost 2.6 times as much as those for the stomach. Further studies are needed (1) to refine the protocol, (2) to improve cost-benefit efficiency, (3) and also to confirm by follow-up that no cases of pancreatic cancer have passed through the test undetected.
Keywords 膵集検 (Mass screening) 早期膵癌 (Early pancreatic cancer) 膵癌の早期診断 (Early diagnosis of pancreatic cancer)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 24
End Page 30
ISSN 09133771
language 日本語
File Version publisher
NAID 120002309153
JaLCDOI 10.18926/19747
Title Alternative Characteristic pancreatographic findings in chronic pancreatitis and their diagnostic value. …Studies on post mortem pancreas…
FullText URL 059_012_016.pdf
Author Tanaka, Juntaro| Matumoto, Shuuji| Ochi, Kouji| Irie, Seiji| Takeda, Masahiko| Harada, Hideo|
Abstract 慢性膵炎25例および対照として正常例125例計150例の新鮮剖検膵を用いて膵管造影を行い,X線所見と同部位の組織所見とを厳密に対比させ,慢性膵炎における各X線所見の診断学的価値を検討した。その結果,主膵管像では不整拡張像,硬化+辺縁不整像,狭窄+辺縁不整像が,分枝像では不整拡張像および不整配列像が,positive predictive value(PPV),specificity(Sf),negative predictive value(NVP)ともに77.1~100% の高率を示した。しかしsensitivity(St)は,2.1~18.1% と低率であった。したがって,これらの所見は慢性膵炎を診断する上で組織予見性および特異性に優れた診断的価値のあるX線所見と言える。しかし一方では軽症の慢性膵炎の検出能はあまりよくないという限界が膵管造影法にはある。
Abstract Alternative Postmortem pancreas tissue was prepared within 6 hours of death for the comparative study of pancreatographic findings and histological findings to define characteristic pancreatographic findings of chronic pancreatitis and determine their diagnostic value. Pancreas tissue was obtained from 25 patients with chronic pancreatitis and 125 with a normal pancreas. Among various pancreatographic findings, irregular dilatation and irregular arrangement of the branches of the pancreatic duct, and also irregular dilatation, rigidity with irregular margin and stenosis with irregular margin of the main pancreatic duct showed the highest sensitivity. specificity, positive predictive value and negative predictive value and conseqently had the highest diagnostic valus. However, the sensitivity was not high enough, indicating that the above pancreatographic findings could be absent at the site of positive histological findings in mild chronic pancreatitis.
Keywords 慢性膵炎 (chronic pancreatitis) 膵管造影像 (pancreatogpaphy)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 12
End Page 16
ISSN 09133771
language 日本語
File Version publisher
NAID 120002309156
JaLCDOI 10.18926/19771
Title Alternative トランスフェリンを介する鉄の細胞内取り込み機序 ―特に肝細胞への取り込みにおける内皮細胞の関与について―
FullText URL 059_083_092.pdf
Author Irie, Seiji| Matsumoto, Shuji| Ochi, Koji| Takeda, Masahiko| Tanaka, Juntaro| Harada, Hideo| Mehdi, Tavassoli|
Abstract Transferrin (Tf) is thought to play a pivotal role in iron metabolism of various kinds of cells. Tf has specific receptors on the surface of the cells that require iron. Tf-receptor binding is followed by internalization through a system of coated pits and vesicles. The rapid decline of pH of these vesicles leads to the release and sequestration of iron by the cell. Apotransferrin-receptor complex returns to the cell surface, where under neutral pH conditions, apotransferrin is dissociated from the receptor. Recent advances in cellular and molecular biology, gene cloning and monoclonal antibody technique have elucidated many features of these processes at a molecular level. These advances are briefly reviewed, and particularly, our own observations concerning endothelial mediation of uptake of Tf by hepatocytes are discussed.
Abstract Alternative トランスフェリン(Tf)は鉄代謝において重要な役割を担っている。鉄を必要とする細胞の表面には,Tfの特異的受容体が存在し,Ffは受容体との結合に引き続いて,coated pitsとcoated vesiclesを介して細胞内に取り込まれる(internalization)。Vesicle内での急速なpHの低下にともない,鉄はTfから分離し,細胞内で分画される。一方,鉄を失ったTf(アポTf)は受容体と結合したまま細胞表面にもどり,中性のpHのもとで受容体から解離する。最近の細胞・分子生物学の進歩,遺伝子クローニング,ならびにモノクローナル抗体の開発により,分子レベルで鉄代謝経路が解明されつつある。今回,これまでの主要な知見をまとめ,特に,最近筆者らの研究により明らかとなった,肝の鉄代謝における内皮細胞の役割について考察した。
Keywords Iron uptake (鉄の細胞内取り込み) Transferrin (トランスフェリン) Receptor-Mediated Endocytosis Desialation (脱シアル化) Endothelium (内皮細胞)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 83
End Page 92
ISSN 0913-3771
language 英語
File Version publisher
NAID 120002309113
JaLCDOI 10.18926/19770
Title Alternative Etiology and pathogenesis of chronic pancreatitis
FullText URL 059_068_082.pdf
Author Harada, Hideo| Matsumoto, Shuji| Ochi, Koji| Takeda, Masahiko| Senou, Toshinobu| Irie, Seiji| Tanaka, Juntaro|
Abstract 慢性膵炎の成因の主たるものは,アルコール性,特発性,胆石性である。病態面では,社会的・家庭的にもっとも責任が重い壮年期に頑固な疼痛,消化吸収障害,二次性糖尿病のために生活の質が低下することが問題になる。経過中に併発してくる膵およびそのほかの臓器の癌,および糖尿病の合併症による死亡も少なくない。アルコール性慢性膵炎の初期病変の発生機序としては,①膵過分泌の結果として細膵管内に形成される蛋白栓による膵液流出障害と,②蛋白栓あるいはアルコールの直接障害作用による細膵管上皮の損傷,およびその結果生じる膵管狭窄による膵液流出障害が注目されている。膵液流出障害はその上流域に実質細胞の破壊と間質の線維化をおこす。膵液には多くの生化学的異常が認められ,いったん発生した膵管の構造異常とあいまって慢性膵炎進展の原因となる。素因および栄養のアンバランスは発症,進展の促進因子となる。発症を予防し,進展を阻止する手段を開発するためには素因および飲酒・食事を含む環境因子の解析が今後の重要な課題である。
Abstract Alternative Main etiologies of chronic pancreatitis (CP)include "alcoholic" (60%), "idiopathic" (27%)and "biliary" (8%). Clinico-pathological features comprise intractable abdominal pain, maldigestion secodary to exocrine pancreatic insufficiency and diabetes secondary to endocrine pancreatic insufficiency. Death is not infrequent during follow-up. Pathogenesis and evolution of alcoholic CP were discussed in connection with "Big Duct Theory", "Toxic-Metabolic Theory", and "Protein Plug Theory". Diet and congenital predisposition as well as alcoholic comsumption play important roles in various combinations in the pathogenesis and evolution of CP. Important initial lesins of alcoholic CP are probably : (1) pancreatic ductular Obstruction due to proetin plug formation resulting from increased protein and mucoprotein concentration in pancreatic juice ; (2) damage and sloughing of ductular epithelia caused by protein plugs or by a direct toxic effect of ethanol secreted into pancreatic juice, and subsequent ductular stenosis and peri-ductular fibrosis. Parenchymal destruction with interstitial fibrosis is induced upstream to the ductular lesions. These, structural abnormalities and multiple biochemical abnormalities of pancreatic juice further lead to self-perpetuating evolution. Anti-acinar-cell antibody, anti-duet-cell antibody and immune complex in serum are most probably mere epiphenomena and not the causes of CP.
Keywords 慢性膵炎 (Chronic pancreatitis) 成因 (Etiology) 発生機序 (Pathogenesis)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 68
End Page 82
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002308982
JaLCDOI 10.18926/19750
Title Alternative Clinical evaluation of endoscopic ultrasonography (EUS) in the diagnosis of gastric disease.
FullText URL 059_017_023.pdf
Author Ochi, Koji| Harada, Hideo| Matsumoto, Shuji| Irie, Seiji| Takeda, Masahiko| Tanaka, Juntaro|
Abstract ラジアルセクタ式超音波内視鏡(EUS)を,15例の胃疾患患者に用い,その有用性を検討した。胃癌の深達度診断は併存潰瘍を有するm癌の1例をsm癌とした以外は,いずれも正診であり,胃癌の深達度診断にEUSが有用であることが示唆された。その他,胃粘膜下腫瘍の占拠部位や発育様式の診断や壁外性圧排との鑑別など胃疾患の診断にEUSの有用性が示唆され,文献的考察を加えて報告した。
Abstract Alternative We performed EUS in seven cases with gastric cancer, one with gastric malignant lymphoma, two with submucosal tumor of the stomach (SMT), two with tumourous compression by extra-gastric organs and three with others. Except one case with early gastric cancer, the depth of cancerous lnvasion was correct1y diagnosed by EUS. It was posible to detect which layer had SMT in the 5 layer strcture of the gastric wall by EUS and it was helpful in determination of histological origin of SMT. Furthermore EUS was able to make the differential diagnosis between SMT and tumourous compression by extra gastric organ. Our result showed that EUS was a useful procedure in the diagnosis of gastric diseases.
Keywords 超音波内視鏡 (Endoscopic ultrasonography) 胃癌 (Gastric cancer) 胃粘膜下腫瘍 (Submucosal tumor of the stomach) 癌深達度診断 (Diagnosis of the depth of cancerous invasion)
Publication Title 環境病態研報告
Published Date 1988-08
Volume volume59
Start Page 17
End Page 23
ISSN 09133771
language 日本語
File Version publisher
NAID 120002309109