JaLCDOI 10.18926/15326
Title Alternative Clinical evaluation of an endoscopic image filing system, Olympus SDF-3
FullText URL 063_074_078.pdf
Author Ochi, Koji| Miyake, Hirofumi| Matsumoto, Shuji| Seno, Toshinobu| Tanaka, Juntaro| Harada, Hideo| Mitsunobu, Fumihiro| Tanizaki, Yosiro|
Abstract 光ディスクとパーソナルコンピュータを組み合わせた内視鏡画像ファイリングシステムは電子内視鏡の画像の保存・管理,検索・再生などに威力を発揮する。今回,われわれはオリンパス社製内視鏡ファイリングシステムSDF-3を使用する機会を得たので,その有用性や問題点の検討を行った。有用性としては,①内視鏡画像を検査終了後直ちに再生し,再検討できる,②多数の項目についての検索や統計処理が可能である,③限られたスペース内で大量の画像データの一括保存・管理が可能であるなどが挙げられる。一方,問題点としては,①内視鏡再生画像は画質が劣化する,②検索機能を十分に活用するにはかなり煩雑な人力操作を必要とする,③光ディスクの清掃が必要であるなどがあげられる。本内視鏡ファイリングシステムに今後必要な改良点やその展望についても合わせて考案を加えた。
Abstract Alternative Olympus SDF-3, an endoscopic image filing system using an electronic endoscope in conjunction with a personal computer and an optical disk, has been recently developed. We evaluated the usefulness of this filing system with 449 cases of gastroduodenal endoscopy. As a result, we have found that this filing system has following advantages : (1) one can review endoscopic images immediately after endoscopic examinations ; (2) previously documented endoscopic image can be searched and reviewed in a short time ; (3) statistical analysis of documented cases is facilitated. However, it has some disadvantages as well to be improved : (1) quality of endoscopic images is deteriorated in the process of filing ; (2) putting patients' data into the filing system is time-consuming ; (3) frequent cleaning of an optic disk is required. This endoscopic image filing system needs to be further developed and refined.
Keywords 画像ファイリングシステム (image filing system) 電子内視鏡 (electronic endoscope)
Publication Title 岡大三朝分院研究報告
Published Date 1992-06
Volume volume63
Start Page 74
End Page 78
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002307278
JaLCDOI 10.18926/11666
Title Alternative Trial of a mass screening survery for detecting early pancreatic cancer
FullText URL 062_005_010.pdf
Author Matsumoto, Shuji| Ochi, Koji| Tanaka, Juntaro| Seno, Toshinobu| Harada, Hideo|
Abstract 早期膵癌を発見するためのスクリーニング法を確立するため,1986年6月1日から1990年6月30日までの期間のprospective studyを行った。対象は,人間ドックを目的として来院した患者を主とする三朝分院の外来患者1,748名である。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,腹部超音波検査(US)を施行し155名の要精検者が得られ,要精検率は8.9%であった。155名の要精検者に,二次検査として,USの再精査,ERCP,腹部CTを施行した。その結果,早期膵癌患者1名,進行膵癌患者4名を発見し,膵癌発見率は0.29%と良好な成績であった。加えて,一次スクリーニングの検査項目を限定することによりcost-benifitを改善することができた。発見された膵癌患者の3名は60歳代であった。また,年代別要精検率は加齢とともに上昇した。1年以後にfollow-up検査を受けた患者の数は641名でfoilow-up率は36.7%であり,そのなかから膵癌は発見されなかった。60歳代のfollow-up率は40歳以上60歳未満のそれにくらべて有意の低値をとった。早期膵癌の見逃しを少なくするためには,今後,60歳代を中心とする患者のfollow-up率をさらに高めることが必要である。
Abstract Alternative To find an effective mass screening method for detecting early pancreatic cancer among asymptomatic populations and patients with vague abdominal symptoms, a prospective study was attempted on 1748 patients who came to Medical Clinic of Misasa Branch Hospital, Okayama University Medical School mostly for a routine annual chek-up from June 1, 1986 through June 30, 1990. These patients underwent first-step screeing tests including serum amylase, elastase I and routine abdominal ultrasonography (US). Consequently 155 patients (8.9% of the total 1748 patients) showed abnormal findings and underwent secondstep tests including US, ERCP and computed tomography. Final diagnosis was early pancreatic cancer in one patient and advanced pancreatic cancer in four. Three of the 5 patients with pancreatic cancer were in their sixties. Detection rate of pancreatic cancer (0.29%) in this series was satisfactory as compared with the results of previous reports with US alone. The rate of second-step examination increased with age. Six hundred and forty-one patients (36.7% of the 1748 patients) underwent follow-up examinations more than one year after the previous test. No pancreatic cancer was detected in the 641 patients. The rate of follow-up examination in patients in their sixties was significantly lower than in those in their forties or fifties. It is important to improve the follow-up rate in patients in their sixties, because they are at a high risk for pancreatic cancer as suggested by the present study.
Keywords 膵集検 (Mass screening for pancreatic cancer) 膵癌の早期診断 (Early diagnosis of pancreatic cancer) 早期膵癌 (Small pancreatic cancer)
Publication Title 環境病態研報告
Published Date 1991-08
Volume volume62
Start Page 5
End Page 10
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313927
JaLCDOI 10.18926/15095
Title Alternative Mechanisms of pancreatic fibrosis
FullText URL 067_115_120.pdf
Author Ochi, Koji| Chowdhury, Riaz| Ichimura, Mitsuko| Matsumura, Naoki| Tanaka, Juntaro| Mizushima, Takaaki| Yamamoto, Ryoichi| Harada, Hideo| Yokota, Satoshi| Mitsunobu, Fumihiro| Hosaki, Yasuhiro| Tanizaki, Yoshiro|
Abstract 膵の線維化は慢性膵炎に特徴的な病理組織所見の一つであるが,その発生機序については不明な点か多い。慢性膵炎はいったん発症すれば,進行性かつ非可逆性であるとされるが,その非可逆性に膵の線維化が関与するとされる。膵の線維化の発生機序を明らかにし,線維化に対する根本的な治療法の確立が望まれるところである。そこで,本稿では今後の膵の線維化の研究課題を明らかにする目的で,現在までの膵臓線維化の発生機序に関する知見を整理した。
Abstract Alternative Pancreatic fibrosis is an outstanding morphological feature in chronic pancreatis although it is seen in pancreatic cancer and convalescent stage of acute pancreatitis. Progressive fibrosis in chronic pancreatitis leads to the destruction and contributes to irreversiblity of chronic pancreatitis. Exact mechanisms of pancreatic fibrosis is not yet unclear, although advances in molecular biology have revealed possible roles of cytokines and growth factors in it. We summarized our understanding of pancreatic fibrosis in the revIew.
Keywords 膵臓 (pancreas) 線維化 (fibrosis) サイトカイン (cytokine) 慢性膵炎 (chronic pancreatitis)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 115
End Page 120
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307876
JaLCDOI 10.18926/19825
Title Alternative Classification and concepts of pancreatitis
FullText URL 060_083_093.pdf
Author Harada, Hideo| Tanaka, Juntaro| Ochi, Koji| Matsumoto, Shuji| Ishibashi, Tadaaki| Seno, Toshinobu| Miyake, Hirofumi|
Abstract 膵炎の分類は膵臓研究の進歩とともに変遷を重ねたが,ここ20年間はマルセイユ分類(1963年)が国際的に広く用いられてきた。しかし最近,膵検査法の進歩と膵研究の知見の蓄積を背景にして,ケンブリッジ(1983年),マルセイユ(1984年),およびローマ(1988年)において分類の改訂を目的に国際シンポジウムが開催され,それぞれに新しい膵炎の分類が提案された。各分類には多くの共通点が見られるが重要な相違点もある。各分類を十分に理解していないとしばらくは混乱に陥ることが危惧される。幸い筆者の1人はこれらのシンポジウムに招待され参加する機会を得たので,成文の背景にある討議を詳しく紹介し,各分類を比較しながらその特徴を述べた。それとともに将来理想的な分類を完成するために今後検討すべき課題をも指摘した。そして,これら分類の当面の利用法に関する筆者らの提案を述べた。
Abstract Alternative The present paper is a review of the historical changes in the classification and concept of pancreatitis. The Marseille classification and concept had enjoyed its international popularity for more than 20 years since it was adopted at the first Marseille symposium in 1962. However, the recent advancement in the study of the pancreas led to the attempts to revise the classification and concept of pancreatitis : International Symposium in Cambridge in 1983, Second International Symposium in Marseille in 1984 and Symposium at the International Congress of Gastroenterology in Rome in 1988. As one of us was invited to the last two symposia, we described the details of the revised classification and concept of Marseille (1984) and of Marseille-Rome (1988) ; then, we described the similarities and differences between the Cambridge classification, the revised Marseille classification and the Marseille-Rome classification. Finally we summarized the subjects to be further investigated to make better classification of pancreatitis in the future.
Keywords 膵炎 分類 (Classification and concepts of pancreatitis) 急性膵炎 (Acute pancreatitis) 慢性膵炎 (Chronic pancreatitis)
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 83
End Page 93
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309066
JaLCDOI 10.18926/14943
Title Alternative Interferon and pancreatitis
FullText URL 070_084_087.pdf
Author Ochi, Koji| Matsumura, Naoki| Mizushima, Takaaki| Hasuoka, Hideaki| Mitsunobu, Fumihiro| Tanizaki, Yoshiro|
Abstract インターフェロンは慢性肝炎や悪性腫瘍の治療など,広く臨床の場に用いられるようになった。その副作用の一つとして,膵炎があり,その多くは急性膵炎である,慢性膵炎の報告もあり,膵炎はインターフェロンを用いる場合に知っておくべき副作用である。そこで,膵炎とインターフェロンの関係について現在までに知られている知見について概説する。
Abstract Alternative Pancreatitis is known to be one of the adverse effects of interferon, which has been widely used for treatment of chronic hepatitis and malignant diseases. In this paper, we reviewed pancreatitis as adverse effects of interferon and effect of interferon on the pancreas.
Keywords インターフェロン (interferon) 急性膵炎 (acute pancreatitis) 慢性膵炎 (chronic pancreatitis)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 84
End Page 87
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308150
JaLCDOI 10.18926/15109
Title Alternative A case of multiple pancreatic cysts with K-ras point mutation in pure pancreatic juice
FullText URL 067_121_125.pdf
Author Yamamoto, Ryoichi| Ochi, Koji| Matsumura, Naoki| Tanaka, Juntaro| Kato, Tadahiro| Mizushima, Takaaki| Chowdhury Riaz| Harada, Hideo| Hasuoka, Hideaki| Yokota, Satoshi| Tanizaki, Yoshiro|
Abstract 膵癌の早期診断を行うために,最近の進歩の著しい遺伝子診断を用いて,膵液中のK-ras遺伝子の点突然変異の検討がなされている。われわれは膵液の細胞診は陰性であるが,K-ras遺伝子の点突然変異を認め,膵全体に多発する膵嚢胞の1例を経験した。本例は悪性であるとの確診が得られないことや切除するとなれば膵全摘となることなどのために,経過観察を行っているが,18カ月後の現在,嚢胞の増大など認めていない。膵癌の遺伝子診断の文献的考察を含め,報告する。
Abstract Alternative Pancreatic cancer is the one of the leading causes of death among cancer deaths and the early diagnosis is one of the main topics of pancreatic research. Mutation of K-ras oncogene at codon 12 has been reported in pancreatic adenoma, hyperplasia of the pancreatic duct, and also in pancreatic cancer, Recently, detection of K-ras point mutation in pure pancreatic juice is underinvestigation as a potential tool of early diagnosis of pancreatic cancer by setting a certain cut-off value. We recently experienced a case of multiple pancreatic cysts without any malignant cells in pancreatic juice, but with a positve point mutation of K-ras oncogene. Operation was deferred after obtaining informed consent from the family, because the lesions were so multiple and extensive as to require total pancreatectomy. Eighteen months follow-up studies did not reveal any deterioration in imaging tests as well as clinical picture.
Keywords 膵嚢胞 (pancreatic cyst) 膵液 (pancreatic juice) K-ras遺伝子 (K-ras oncogene) 点突然変異 (point mutation) 細胞診 (cytology)
Publication Title 岡大三朝分院研究報告
Published Date 1996-11
Volume volume67
Start Page 121
End Page 125
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307457
JaLCDOI 10.18926/11698
Title Alternative Diabetic complications in the advanced stage of chronic pancreatitis.
FullText URL 061_079_088.pdf
Author Ochi, Koji| Tachibana, Hideo| Matsumoto, Shuji| Seno, Toshinobu| Tanaka, Juntaro| Harada, Hideo|
Abstract 慢性膵炎が進行すると膵内外分泌不全に対する治療が主体となる。かつては膵疾患に由来する糖尿病(膵性糖尿病)においては糖尿病性合併症の発症が少ないとされていたが,慢性膵炎の長期経過観察例の増加とともにその頻度が一次性糖尿病にくらべて必ずしも低くないことが指摘されるようになった。そこで今回,厚生省難治性膵疾患調査研究班「慢性膵炎の新しい治療法の開発」小委員会の研究活動の一環として膵性糖尿病の治療法を再検討することになったのを機会に,その手始めに野性糖尿病の合併症に関する従来の報告を整理した。その結果,一次性糖尿病の場合にくらべて,細小血管症(網膜症,腎症,神経障害)はほぼ同程度であるが軽症例が多いこと,大血管症(心筋梗塞,脳硬塞,動脈硬化症)は少ないことが示唆された。そのほか,膵性糖尿病の合併症の発症に関与すると考えられる諸因子についても概説した。
Abstract Alternative Exocrine dysfunction (maldigestion) and endocrine dysfunction (diabetes) are malll clinical features in the advanced stage of chronic pancreatitis. Diabetic complications were previously considered to be infrequent in diabetes secondary to chronic pancreatitis (pancreatic diabetes). However, the recent improvement in life expectancy and closer observation of the clinical course of patients with chronic pancreatitis have revealed that diabetic complications are not infrequent in pancreatic diabetes as compared with primary diabetes mellitus and that diabetes is one of the most important prognostic factors in chronic pancreatitis. We, therefore, reviewed recent articles on the topics before beginning a national survey of diabetic complications in patients with pancreatic diabetes. It has been suggested that : (1) diabetic microangiopathy (retinopathy, nephropathy and peripheral neuropathy) is almost as frequent in secondary diabetes as in primary diabetes, although the severity is less in secodary diabetes : (2) peripheral neuropathy is frequent in alcoholic chronic pancreatitis : (3)macroangiopathy (myocardial infarction, cerebral thrombosis, atherosclerosis) is less frequent in pancreatic diabetes. We also discussed various factors which may precipitate the diabetic complications.
Keywords 膵性糖尿病 (Pancreatic diabetes) 慢性膵炎 (Chronic pancreatitis) 合併症 (Complications)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 79
End Page 88
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313469
JaLCDOI 10.18926/19662
Title Alternative Effect of aging on pancreatic exocrine function -Aging and fecal chymotrypsin activity-
FullText URL 057_024_028.pdf
Author Matsumoto, Shuji| Harada, Hideo| Ochi, Koji| Takeda, Masahiko| Tanaka, Juntaro| Morinaga, Hiroshi| Yoshida, Mitsuo| Kimura, Ikuro|
Abstract 膵外分泌機能に及ぼす加齢の影響を検討する目的で,健常人43名,非膵疾患患者41名,老人ホーム入居者39名を対象として比色法により糞便中キモトリプシン活性(FCA)を測定し,以下の結論を得た。1)FCAは逐齢的に低下し,60歳以上は60歳未満より有意の低値を示した。しかし,分布図のretrospectiveな検討からは,膵外分泌機能の低下は,実際には65~70歳あたりから明らかになることが示唆された。2)FCAの正常下限値を14.5U/gに定めたが,高齢者の診療にあたってはこの正常値のみを根拠にして疾病の有無を判定すべきではない。3)老人ホーム入居者のFCAは特に低値を取ったがその主要因は高齢者が多いためと考えられた。
Abstract Alternative To examine the effect of aging on the pancreatic exocrine function, fecal chymotrypsin activity (FCA) was measured by the photometric method in 43 healthy controls, 39 controls in an old-age home and 41 patients with non-pancreatic diseases. Following conclusions were obtained. 1) Pancreatic exocrine function showed a significant decrease with aging as indicated by the present prospective study : ① a significantly lower FCA in the B group of 22 healthy controls (≧ 60 years of age) than the A group of 21 healthy controls (< 60 years of ago) ; ② significant correlationship between aging and FCA in the 43 healthy controls and also in the 41 patients with non-pancreatic diseases. 2) FCA in controls in an old-age home was especially low. Presumably it was due to their far-advanced aging. 3) The calculated lower limit of normal in FCA was 14.5U/g. However, the diagnosis of pancreatic diseases should not be coined solely on the basis of decreased FCA value.
Keywords 糞便中キモトリプシン活性 (Fecal chymotrypsin activity) 加齢 (Aging) 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 1986-07
Volume volume57
Start Page 24
End Page 28
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309096
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 10.18926/19775
Title Alternative Effect of long-term daily intake of thermal water on gastric mucosal blood flow
FullText URL 060_001_005.pdf
Author Tanaka, Juntaro| Senou, Toshinobu| Matumoto, Shuji| Ishibashi, Tadaaki| Ochi, Koji| Harada, Hideo|
Abstract 内視鏡(オリンパス製XQ-10胃ファイバースコープ)と臓器反射スペクトル法を応用して,2週間連日の飲泉が胃粘膜血流におよぼす効果を検討した。健常者3名および胃疾患患者9名(治癒期にある胃潰瘍の患者6名と慢性胃炎の患者3名)を対象とした。当院飲泉場の温泉水による2週間連日の飲泉を行ない,2週間の飲泉の前後において,胃の3箇所(胃幽門部小弯,前庭部小弯,胃角部小弯)で胃粘膜血流を測定した。その結果,胃前庭部小弯では胃粘膜血流の有意の増加を認めた。しかし胃全体としては有意差を検出出来なかった。個々の症例について検討すると、飲泉後で胃の3箇所すべてにおいて血流が増加したケースが頻度多く認められ,飲泉の有効性が示唆された。従来から認められてきた慢性胃腸疾患に対する飲泉の効果には,胃粘膜血流の改善による要因も加わっている可能性が考えられる。
Abstract Alternative Effect of long-term oral intake of thermal water on gastric mucosal blood flow was evaluated, using an endoscopic organ reflex spectrophotometry together along with an Olympus XQ-10 forward viewing gastro-fiberscope. Three healthy volunteers and nine patients with gastric diseases in remission (six with healed gastric ulcer and three with chronic gastritis) were put on a 2-week treatment with daily oral intake of Misasa thermal water (38 to 42 ℃, 200mℓ, two times a day between meals). Gastric mucosal blood flow was measured just before and after the treatment period at three spots of the stomach (lesser curvature of the pylorus, antrum and angle) : Life style and drugs were unchanged during the period. Following results were obtained : (1) Pre-and post-treatment gastric mucosal blood flow (IHb) was 95.0±18.0, and 98.2±15.3 at the pylorus, respectively ; 104.8±16.9 and 110.8±12.8 at the antrum, respectively ; 116.1±20.4 and 118.7±18.5 at the angle, respectively. (2) However, Evaluation of each individual case showed that the post-treatment values were higher than the pretreatment ones in 75 % of patients at the pylorus and in 67 % of patients at the antrum and angle, respectively. (3) Student's paired t-test showed that the post-treatment increase in blood flow was statistically significant (p<0.05) only at the antrum. These results suggest that an improvement in gastric mucosal blood flow, along with an improvement in gastric secretion and motility, is also contributory to the favorable therapeutic results of spa-drink in chronic gastric diseases. Further studies are in progress to reveal (1) the clinical significance of the improvement in gastric mucosial blood flow, such asacceleration of healing and maintenance of remission, and (2) the characteristics of patients who are likely to show favorable response to the treatment.
Keywords 飲泉療法 (Spa-drink therapy) 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 1989-07
Volume volume60
Start Page 1
End Page 5
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309006
JaLCDOI 10.18926/21087
Title Alternative Endoscopic diagosis of gastric malignant lymphoma
FullText URL pitsr_056_045_052.pdf
Author Miyake, Hirofumi| Harada, Hideo| Yasuoka, Masatoshi| Oka, Hiroo| Matsumoto, Shuji| Ochi, Koji| Takeda, Masahiko| Tanaka, Juntaro| Ohnoshi, Taisuke| Kimura, Ikuro|
Abstract To delineate the pitfalls and counter-measures in the endoscopic diagnosis of gastric malignant lymphoma (GML), reviewed were 32 cases of primary GML and 16 cases of systemic ML with gastric involvement (secondary GML). 1) Accurate diagnosis of GML had been made in only 13 cases of primary GML ; 18 cases had been diagnosed of gastric cancer (GC); the remaining one of benign ulcer (BU). Review of the endoscopic films, however, revealed more than two of the three findings characteristic, but not pathognomomic, of GML in 84 percent. This result indicates that possibility of GML must be kept in mind in the differential diagnosis of malignant lesions despite its rarity, because endoscopists tend to be predisposed with an impression of GC. 2) Follow-up examinations made in nine cases of primary GML revealed marked changes in endoscopic findings in three cases : healing of an ulcer lesion in one case, healing of an ulcer lesion on an unchanged tumor in another and enlargement of a tumor in the remaining one. The first case had been followed up for two years with an impression of BU. This result indicates that improvement of ulcer does not necessarily rule out GML because it can show "malignant cycle" just as GC. 3) Endoscopic biopsy performed in 30 cases of primary GML had led to accurate diagnosis in only 16 cases and erroneous diagnosis of GC in five and no malignancy in nine. Review of the cases revealed the importance of having suspicion of GML at first from endoscopic findings, because it can lead to an increase of the number of biopsy specimens, careful selection of biopsy sites, careful use of biopsy instruments to obtain good specimens and closer contact with pathologists. 4) Prospective studies on systemic ML revealed gastric involvement in 17 percent. Examinations of the GI tract, especially of the stomach is one of the important steps for staging of systemic ML and deciding therapeutic modalities. 5) It is extremely difficult to diffierentate primary GML and secondary GML from endoscopic findings alone, although there are a few findings characteristic of the latter.
Publication Title 岡山大学温泉研究所報告
Published Date 1985-03-30
Volume volume56
Start Page 45
End Page 52
ISSN 0369-7142
language 日本語
File Version publisher
NAID 120002310992
JaLCDOI 10.18926/11674
Title Alternative Development of stepping measurement device for evaluation of and training in walking
FullText URL 061_123_128.pdf
Author Matsumoto, Shuji| Ochi, Koji| Tanaka, Juntaro| Tachibana, Hideo| Seno, Toshinobu| Harada, Hideo| Tsuboi, Keiichi| Miyake, Hirofumi| Kimura, Ikuro|
Abstract 急性膵炎の回復後その発症原因の検索において発見された小膵癌の3例を報告し,膵炎の発症原因の一つとして膵癌を常に念頭におく必要があることを強調した。またスクリーニング検査および精査において小膵癌を診断する手順について考察を加えた。症例1は初回発作の回復後に,症例2および症例3は再発発作の回復後に急性膵炎の発症原因の検索を目的に紹介された。いずれの症例においても血清腫瘍マーカーは正常植を示し,腹部USおよびCTは腫瘍から尾側の膵管の拡張を示したが腫瘍そのものは描出はできなかった。症例1ではERCP像から膵体部癌を強く疑い,症例2と症例3ではERCP像と細胞診陽性所見から膵頭部癌と確診し,手術を行った。腫瘍の最大径は症例1では0.9cm,症例2では1.5cm,症例3では2.0cmであり,いずれも転移を認めず根治切除可能であった。
Abstract Alternative Although gait training equipment such as the bicycle ergometer and treadmill exists for patients whose walking ability is high, there is no appropriate gait training mehtod or training instrument for patients whose walking ability has become impaired, who often use a cane or walker, etc. in the course of daily life. In the case of gait training for persons whose walking ability involves impaired locomotion, there is always the danger of a fall. Consequently, a caregiver is required, and the effect of the training is cut by half because the patient's anxiety about falling is exacerbated. Slow stepping affords strengthening and balance training of the leg muscles for patients whose walking ability has become low, and walking ability is improved. However,whether such training appropriately carries out stepping and the degree of the effect of such training has not been evaluated. Therefore, we have developed a stepping measturement device that monitors stepping for evaluation and training of walking ability. This system consists of two mat switches for stepping, a measuring circuit for stepping detection, and a book-sized personal computer with a PC card-type AD converter. This system can detect a left or right single stance phase and a double stance phase relative to the ON, OFF condition of the mat switch. After measurement, the following items are analyzed and displayed : ・number of steps, ・average time of double stance phase, ・the average time of single stance phase, and so on. Finally, we measured the stepping of subjects whose walking ability is low, and showed the relationship between daily walking conditions and stepping conditions. The effectiveness of this system was considered in light of the results.
Keywords 小膵癌 (Small pancreatic cancer) 膵癌の早期発見 (Early diagnosis of pancreatic cancer) 急性膵炎 (Acute pancreatitis)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 123
End Page 128
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313750
JaLCDOI 10.18926/19821
Title Alternative Interstitial matrix components in relation to the pathogenesis of fibrosis
FullText URL 060_076_082.pdf
Author Seno, Toshinobu| Harada, Hideo| Ochi, Koji| Tanaka, Juntaro| Matsumoto, Shuji| Ishibashi, Tadaaki| Takeda, Masahiko| Miyake, Hirofumi|
Abstract 慢性膵炎の症例は近年増加の一途をたどっており,その発症機序と病態の解明および対策の確立が急がれている。慢性膵炎の重要な所見の一つである膵間質線維化の発生機序の解明および早期発見法の確立は重要な課題であるが,従来の知見は断片的にすぎない。そこで,筆者らは膵線維化の系統的な研究を始めるにあたって,細胞間マトリックスの構成成分と線維化に関する従来の知見および今後の課題を整理した。細胞間マトリックスのうちでも特にコラーゲン,グリコサミノグリカン,フィブロネクチンをとりあげ,その構造と機能および組織の線維化形成における役割について文献的考察を行った。今後,膵組織および膵液中のプロリンハイドロキシラーゼ,コラーゲンとその型別分布および各型コラーゲンの比,ヘキソサミン,デルマタン硫酸,フィブロネクチン,ラミニンを検討することが重要と思われた。
Abstract Alternative Increasing numbers of patients with chronic pancreatitis have been reported all over the world, including Japan. Pathogenesis of chronic pancreatitis has remained to be revealed and the early detection has remaind difficult despite extensive investigations. Interstitial fibrosis forms one of the most important histopathological features of chronic pancreatitis along with loss of parenchyma and irregular dilatation of the ducts and ductules. However, only a limited numbers of reports have been pubiished on the pathogenetic mechanisms of interstitial fibrosis of the pancres, because tissue materials are not easily accessible and blood samples can hardly reflect the fibrotic process of the pancreas unlike the case of the iiver. Our Preliminary studies revealed that biochemical and immunochemical analysis of pure pancreatic juice, such as determination of collagen, hexosamine, fibronectin and proline hydroxylase, might reflect the fibrotic process of the pancreas. The results led us to review the earlier reports on inter-cellular matrix in relation to the formation of fibrosis to find suitable markers to be evaluated in the future systematic investigations. The review revealed that pure pancreatic juice should be analyzed for collagen, types of collagen, hexosamine, dermatan sulfate, fibronectin, larninin, proline hydroxylase, collagenase and cathepsin B(1).
Keywords 慢性膵炎 (Chronic pancreatitis) 膵の線維化 (Interstitial fibrosis of the pancreas) 膵間質成分 (Interstitial matrix of the pancreas)
Publication Title 環境病態研報告
Published Date 1989-07
Volume volume60
Start Page 76
End Page 82
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002309179
Author Takuma, Masae| Masui, Etsuko| Hayashimoto, Kanae| Asaumi, Noboru| Tachibana, Hideo| Ochi, Koji| Harada, Hideo|
Published Date 1991-08
Publication Title 環境病態研報告
Volume volume62
Content Type Others
JaLCDOI 10.18926/15127
Title Alternative Spa therapy and quality of life in patients with bronchial asthma
FullText URL 066_072_077.pdf
Author Tanizaki, Yoshiro| Mifune, Takashi| Mitsunobu, Fumihiro| Kajimoto, Kazuhiro| Hosaki, Yasuhiro| Yokota, Satoshi| Ochi, Koji| Harada, Hideo| Ikeda, Satoru| Taketa, Kazuhisa|
Abstract 気管支喘息のなかでも,ステロイド依存性重症難治性喘息では,気管支拡張薬その他の抗喘息薬のみでは発作のコントロ-ルが極めて困難であり,したがって副腎皮質ホルモンの長期投与を余儀なくされる。そして,投与薬剤,特に気管支拡張薬の心臓刺激作用や副腎皮質ホルモンの副作用,さらには運動誘発喘息がひき起こされやすいなどの理由により,体動制限が加えられることが多い。このことが,また精神活動の低下へとつながる。したがって,重症難治性喘息患者のQuality of life (QOL)を高めるためには,薬剤の副作用をできるだけ低くするための投与薬剤の減量をはかるとともに,十分な運動のもとに治療を行い全身状態の改善,それにともなう精神活動の活性化をはかる必要がある。かかる観点からすれば,温泉療法は最も理想的な治療法であり,その直接作用(気道への作用:気道浄化作用,気道粘膜正常化作用)により,白,他覚症状の改善,換気機能の改善,気道過敏性の低下などが観察される。また,間接作用(気道以外への作用)により,全身状態の改善,自律神経系の安定化作用,副腎皮質機能の改善作用などが見られる。すなわち,重症難治性喘息に対する温泉療法では,十分な運動のもとに,精神活動の活性化をともなった喘息症状の改善がはかられるため,患者のQOLをより一層高めることができると判断される。
Abstract Alternative Bronchial asthma is in qeneral a disease with good prognosis and can be controlled with usual antiasthmatic drugs. However, there are some patients whose asthma attacks can be controlled only with use of qlucocorticoids. In these patients, adverse side effects of many kinds of drugs containing bronchodilators and qlucocorticoids, and exercise-induced asthma attacks are often observed. Thus, the patients have to keep limitation of exercise during treatment of their asthma attacks, leading to decrease psychical activity. Complex spa therapy for bronchial asthma consists of swimming training in a hot spring pool (exercise), inhalation of iodine salt solution and fango therapy. Spa therapy has two kinds of actions : direct action to airways and indirect action to other organs except airways. The direct action of spa therapy improves subjective and objective symptoms, and ventilatory function, and suppress bronchial hyperresponsiveness. In contrast, improvemment of suppressed function of adrenocortical glands, of mental activity, and of autonomic nerve system is observed as indirect action of spa therapy. These actions play an important role for improvement of QOL of patients with bronchial asthma.
Keywords 温泉療法 (spa therapy) 重症難治性喘息 (lntractable asthma) 運動 (exercise) 精神活動 (phychical activity) QOL
Publication Title 岡大三朝分院研究報告
Published Date 1995-09
Volume volume66
Start Page 72
End Page 77
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307919
JaLCDOI 10.18926/11708
Title Alternative Re-evaluation of spa-drink therapy for digestive diseases
FullText URL 061_073_078.pdf
Author Tanaka, Juntaro| Seno, Toshinobu| Matsumoto, Shuji| Ochi, Koji| Harada, Hideo|
Abstract 従来飲泉などの温泉治療は経験的知識にもとづいて行われる部分が多かったが,今後は科学的検査法を用いて有用性,適応疾患,適応病態,などを決定する必要がある。筆者らは,最近紹介された簡便な消化器検査法を用いて消化器疾患に対する飲泉療法の適応を再吟味しているので,これまでに得られた成績を中心に概説した。すなわち,(1)飲泉は1回でも連日の飲用でも,胃粘膜血流を改善する作用がある。(2)胃排出機能に対しては調整的効果を有する。(3)連日の飲泉は膵外分泌機能を改善する。したがって慢性の胃,膵疾患において粘膜血流障害,胃運動機能異常あるいは膵外分泌機能低下に起因する病気・病態に対しては積極的に飲泉療法を試みるべきである。温泉水の温度は40℃前後,飲泉の量は150~200ml,タイミングは食間空腹時がよい。
Abstract Alternative With the advent of new instruments for examining the digestive organs, we have attempted to re-evaluate the efficacy and indications of spa-drink therapy for digestive diseases. This report deals with an overview of the results we have obtained so far. Effect of oral intake of thermal water (Misasa thermal water, 38-42℃, 150-200 ml) on gastric mucosal blood flow was evaluated, using an endoscopic organ reflex spectrophotometry together along with an Olympus XQ - 10 forward viewing gastrofiberscope. Single intake of thermal water as well as long-term spa-drink therapy (two times a day between meals for more than two weeks) brought about an improvement of gastric mucosal blood flow. Gastric emptying function was evaluated with an acetaminophen method. Single intake of thermal water brought about disordered gastric emptying (excessively accelerated or suppressed). However, long-term spa-drink therapy brought about an improvement (normalization) of gastric emptying function. Exocrine pancreatic function was evaluated with a synthetic peptide, N-BT-PABA, and also by measuring fecal chymotrypsin actIvIty. Longterm spa-drink therapy brought about an improvement of exocrine pancreatic function. Motility of the gall-bladder was evaluated by abdominal ultra-sonography. Long-term spa-drink therapy gave no effect on the motility of the gallbladder. In conclusion, our recent study indicate that : (1) single oral intake of thermal water as well as longterm spa-drink therapy is effective for gastric diseases related to decreased gastric mucosal blood flow (treatment of intractable peptic ulcer and chronic gastritis, and prevention of recurrence of peptic ulcer) ; (2) long-term spa-drink therapy is effective for dyspepsia syndrome; (3) long-term spa-drink therapy is effective as a supplemental method in the treatment of exocrine pancreatic dysfunction (chronic pancreatitis) ; (4) thermal water should be taken between meals.
Keywords 飲泉療法 (Spa-drink therapy) 消化器機能 (Digestive function) 胃粘膜血流 胃排出能 膵外分泌 胆嚢機能
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 73
End Page 78
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313368
JaLCDOI 10.18926/14921
Title Alternative Spa therapy for patients with asthma. A study on 437 patients with asthma admitted for last 5 years.
FullText URL 070_001_008.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Takata, Shingo| Ochi, Koji|
Abstract 1994年1月より1998年12月までの5年間に当院へ入院した呼吸器疾患のなかで気管支喘息を対象に,年齢,地域分布などの経年変化について検討を加えた。1.最近5年間に当院へ入院した呼吸器疾患患者は664例で,このうち,気管支喘息は437例(65.8% )であった。呼吸器疾患のなかで気管支喘息に占める割合の経年変化では,1995年度が最も高く(74.4% ),1997,1998年度にはやや低下(ともに60.7% )の傾向が見られた。2.入院患者の地域分布では,鳥取県内からの入院患者に比べ,遠隔地(鳥取県外)からの入院患者が比較的多く,いずれの年度においても50% 以上(平均57.3% )であった。また,岡山,大阪,兵庫,広島,山口,愛媛県などからの入院症例が多い傾向か見られた。3.年齢別検討では,いずれの地域においても,高齢者の入院症例か多く,鳥取県内では70才以上の症例の頻度(平均35.1% )が,また遠隔地(鳥取県外)では60-69才の症例の頻度(平均37.7% )が高い傾向か見られた。
Abstract Alternative The parients with asthma who were admitted at our hospital for last 5 years (1994-1998) were examined in relation to age and areas where patients came. 1. Of 664 patients with respiratory disease admitted for last 5 years, 437 patients (65.8% ) had asthma. The frequency of asthma in all patients with respiratory disease was the highest (74.4% ) in 1995, and decreased in 1997 and 1998 (60.7% ). 2. The number of patients with asthma from distant areas (outside Tottori prefecture) was constantly larger than the number of those inside Tottori prefecture in each year. The number of patients from Okayama, Osaka, Hyogo, Hiroshima, Yamaguchi, and Ehime was larger than the number from other distant areas. 3. Regarding the distribution of age of these patients, the number of patients over the age of 60 was more frequently observed, regardless of the area where patients came. Larger number of patients over the age of 70 (35.1% ) was found in those inside Tottori prefecture, while the number of patients between the ages of 60 and 69 (37.7% ) was larger in those from distant areas.
Keywords 気管支喘息 (asthma) 温泉療法 (spa therapy) 高齢患者 (aged patients) 遠隔地 (distant area)
Publication Title 岡大三朝分院研究報告
Published Date 1999-12
Volume volume70
Start Page 1
End Page 8
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308420
JaLCDOI 10.18926/15162
Title Alternative Clinical opplication of a newly developed radiographic system including a fluoroscope equiped with CCD and digital image processor
FullText URL 065_107_114.pdf
Author Akiyama, Tsuneo| Nakai, Mutsuo| Kajimoto, Kazuhiro| Mitsunobu, Fumihiro| Mifune, Takashi| Tanizaki, Yoshiro| Ochi, Koji| Riaz, Chowdhury| Satou, Masataka| Ukon, Hiroe|
Abstract 画像の入力部に世界初100万画素の多画素・高精細のCCD(電荷結合素子)を用いたテレビカメラを搭載したX線テレビ装置とDigital・Radiography装置を導入し,主に消化管検査を中心に多目的に任用した。このシステムは従来のscreen/filmシステムの持つ膨大な情報量を確保しながらCCDカメラのメリットを最大限に生かしており,DRシステムの特長であるリアルタイムのCRT撮影画像表示,透視像のFREEZE確認,動態解析,画像処理等を導入することにより診断能の向上がはかれた。更に,従来X線フィルム・撮像管に比較して被曝量の大幅な低減が期待できた。また,デジタルであるため撮影像をHDに保管すると共にMODにも記録・再生が可能である。今後,PACSやフイルムレス電子媒体保管への展開の可能性についても確認できた。
Abstract Alternative We have clinically applied a newly developed radiographic system which was introduced into our institute in April 1994. This system consists of a fluoroscope, CCD (charge-coupled device) which had a million matrix, and digital image processor. This system has following advantages comparison with a conventional radiographic system ; (1) doses of x-ray exposuce during examination is less, (2) a sharp fluoroscopic image can be obtained by real-time image processing, (3) radiographic images can be kept in the recording device such as hard disc (HD) and magnetic optical disc (MOD) since this has a digital radiographic system. By connecting this system with main online system, it is expected to be able to see the various diagnostic images simulataneously as well as laboratory data at different spots of the hospital which is now available in other hospltal.
Keywords 増感紙/フイルム (Screen/Film) 光電子増倍管 (Image・Intensifier (l・I)) デジタル・イメージング (Digital・Imaging) 電荷結合素子 (CCD) 光磁気ディスク (MOD) デジタルラジオグラフィ (Digital Radiography)
Publication Title 岡大三朝分院研究報告
Published Date 1994-09
Volume volume65
Start Page 107
End Page 114
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002307511
JaLCDOI 10.18926/14950
Title Alternative Clinical significance of spa therapy in the treatmentof patients with chronic obstructive pulmonary disease (COPD). A study on 511 patients with COPD admitted for last 5 years
FullText URL 069_001_008.pdf
Author Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Mifune, Takashi| Hosaki, Yasuhiro| Ashida, Kozo| Tsugeno, Hirofumi| Okamoto, Makoto| Harada, Seishi| Yumoto, Eiichiro| Takata, Shingo| Ochi, Koji| Harada, Hideo|
Abstract 1993年1月より1997年12月までの5ヵ年間に当院へ入院した慢性閉塞性呼吸器疾患511例を対象に,疾患の種類,年齢,地域分布などについて検討を加えた。1.最近5年間に当院へ入院した呼吸器疾患患者は594例で,このうち,慢性閉塞性呼吸器疾患患者は511例(86.0%)であった。これらの慢性閉塞性呼吸器疾患のなかでは,気管支喘息が416例(81.4%)と最も多く,その他.慢性気管支炎20例,閉塞性細気管支炎27例,肺気腫48例であった。2.慢性閉塞性呼吸器疾患のなかでは,肺気腫の症例が増加する傾向が見られた。3.慢性閉塞性呼吸器疾患の年齢別検討では,鳥取県内では,70才以上の症例が,また遠隔地(鳥取県外)では60-69才の症例の頻度が高い傾向が見られた。4.入院患者の地域分布では,鳥取県内からの入院患者に比べ,遠隔地(鳥取県外)からの入院患者が比較的多く,その比率は1997年度で48.4%であった。また,その分布別検討では,岡山県,兵庫県,大阪府,広島県,山口県,愛媛県からの入院患者が多い傾向が見られた。
Abstract Alternative The kind of respiratory disease, age, and areas where patients came from were analyzed in 511 patients with chronic obstructive pulmonary disease (COPD) admitted at Misasa Medical Branch for last 5 years from 1993 to 1997. 1.For the last 5 years 594 patients with respiratory diseases were admitted at Misasa Medical Branch. Of these patients 511 (86.0%) were those with COPD. Of the 511, 416 (81.4%) were patients with asthma, 20 with chronic bronchitis, 27 with obstructive bronchiolitis, and 48 with pulmonary emphysema. 2.The number of patients with pulmonary emphysema showed a tendency to increase in recent years. 3.Regarding the distribution of age of these patients, the number of patients over the age of 60 was larger than the number of patients under the age of 59:patients between the ages of 60 and 69 were more frequently observed in those coming from distant area (outside Tottori prefecture), and those over the age of 70 in those coming from Tottori prefecture. 4. The number of patients from distant areas (outside Tottori prefecture) was considerably larger (48.4% in 1997) compared to the number of patients from Tottori prefecture. The number of patients from Okayama, Hyogo, Osaka, Hiroshima, Yamaguchi and Ehime was predominantly larger than the number of patients from other distant areas.
Keywords 慢性閉塞性呼吸器疾患 (COPD) 気管支喘息 (bronchial asthma) 温泉療法 (spa therapy) 高齢患者 (aged patients) 遠隔地 (distant area)
Publication Title 岡大三朝分院研究報告
Published Date 1998-12
Volume volume69
Start Page 1
End Page 8
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308114
JaLCDOI 10.18926/14992
Title Alternative Endoscopic aspiration of pure pancreatic juice is useful in diagnosis and treatment of chronic pancreatitis.
FullText URL 068_094_098.pdf
Author Ochi, Koji| Matsumura, Naoki| Kato, Tadahiro| Mizushima, Takaaki| Ichimura, Mitsuko| Harada, Hideo| Tanizaki, Yoshiro| Mitsunobu, Fumihiro| Hasuoka, Hideaki| Tsurumi, Tetsuya|
Abstract 内視鏡的純粋膵液採取法の慢性膵炎診療における意義を検討した。本法を用い,セクレパン100単位静注後10分間膵液を採取するintaraductal secretin test(IDST,膵管内セクレチン試験)はこれまで膵外分泌機能検査のgold standardである十二指腸液を採取するセクレチン試験に代用ができ,しかも10分間の採取時間で終了する利点を有する。本法を施行することにより,蛋白栓が除去され,痔痛の消失に有用である。また,慢性膵炎と鑑別を要する膵癌を除外診断するために,本法によって採取した膵液の細胞診,腫瘍マーカー,癌遺伝子の検出は有用である。
Abstract Alternative Endoscopical aspiration of pure pancreatic juice is useful in following aspects. Firstly, intraductal secretin test by using this method can be substituted for duodenal secretin test, which is a gold standard examination for estimation of exocrine pancreatic function. In addition, endoscopic aspiration of protein pluge eliminates abdominal pain of some painful patients with chronic pancreatitis. Cytological examination, determination of tumor marker, and detection of oncogene in the obtained pancreatic juice are complementary diagnostic approach to pancreatic cancer, which must be differentially diagnosed from chronic pancreatitis.
Keywords 慢性膵炎 (chronic pancreatitis) 膵液 (pancreatic juice) 内視鏡 (endoscopy) 膵外分泌機能検査 (exocrine pancreatic function test)
Publication Title 岡大三朝分院研究報告
Published Date 1997-12
Volume volume68
Start Page 94
End Page 98
ISSN 0918-7839
language 日本語
File Version publisher
NAID 120002308491