JaLCDOI 10.18926/11705
Title Alternative Clinical study on polypoid lesions of the colon
FullText URL 061_036_040.pdf
Author Ochi, Koji| Harada, Hideo| Matsumoto, Shuji| Seno, Toshinobu| Tanaka, Juntaro| Tachibana, Hideo| Akiyama, Tsuneo| Nakai, Mutsuo|
Abstract 1986年4月から1990年2月末までの間に岡山大学医学部附属病院三朝分院で経験した早期大腸癌を含む大腸ポリープ90例(107病変)を対象に,年齢,臨床症状,便潜血反応,病変存在部位について検討を行い,以下の成績を得た。(1)大腸検査総数の22.4%にポリープが発見された。ポリープの77%は腺腫,5%は腺癌(早期癌)であった。(2)便潜血反応はポリープ例の75.9%に陽性であり,右側大腸ポリープでの陽性率は高かったが,S状結腸および直腸ポリープでは70%程度であった。(3)若年者では右側結腸にポリープが発見されることは稀であるが,50才以上では18%程度に認められた。高齢者では右側結腸も内視鏡で検査することが重要である。(4)免疫学的便潜血検査法の導入により大腸ポリープの発見効率が改善するものと考え られた。
Abstract Alternative This report is concerned with clinical study on 90 patients with polypoid lesions (107 lesions) which we have encountered in Misasa Hospital, Okayama University in the past 4 years. Following results were obtained : (1) Polypoid lesions were detected in 90 (22.4%) and advanced adenocarcinoma (mostly resectable) in 22 (5.5%) of 402 patients who were examined by sigmoidoscopy and barium enema ; (2) Histological examination of the polypoid lesions showed adenoma in 77.2%, hyperplastic polyp in 8.7%, inflammatory polyp in 7.6%, neurinoma in 0.3% and early cancer (adenocarcinoma) in 5.4% ; (3) It was impossible to differentiate benign and malignant polypoid lesions on the basis of endoscopic and X-ray findings alone ; (4) Forty-two percent of the polypoid lesions was detected in the sigmoid colon, 30% in the rectum, 16.8% in the descending colon, 9.3% in the ascending colon, 0.9% in the caecum ; (4) Patients younger than 50 years of age showed only one polypoid lesion in the right hemicolon, whereas elder patients showed as many as 17 polypoid lesions ; (5) Among the 90 patients with polypoid lesions, 40 presented with abdominal pain, 20 with no symptoms (annual health check-up), 17 with irregular bowel habits, and 10 with melena ; (6) Among the 90 patients, occult blood in stool was positive in 75.8% with a lower positive rate in the lesions of the sigmoid and rectum ; (7) Among 5 asymptomatic patients with lesions and with a negative hemoccult test, 3 patients with a polypoid lesion were examined because of the patients' request, 1 patient with a polypoid lesion because of a positive family history, and the remaining 1 patient in a search for the primary lesion of the metastatic liver cancer ; (8) Among patients with a positive hemoccult test, the detection rate of polypoid lesions was 41.9% with use of an immunological method, whereas it was 19.7% with use of a chemical method. In conclusion, (1) detection of colonic polypoid lesions can lead to the detection of early cancer, although only histological examination can confirm the accurate diagnosis ; (2) a hemoccult test in stool with an immunological method is an effective method for screening asymptomatic colonic polypoid lesions, although it must be admitted that negative results may occasionally occur ; (3) macroscopic observation of the stool mass is important before sampling, because lesions of the sigmoid colon or the rectum may show scanty blood only on the limited area of the surface of the stool ; (4) patients elder than 50 years of age should be examined more carefully for the whole colon preferably with an endoscope, because they show a high incidence of small polypoid lesions in the right hemicolon.
Keywords 大腸ポリープ (Polyp of the colon) 大腸早期癌 (Early cancer of the colon)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 36
End Page 40
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313590
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 10.18926/11697
Title Alternative Strategies of community health activities to improve the quality of inhabitants' life
FullText URL 011_1_041_048.pdf
Author Ninomiya, Kazue| Okano, Hatsue| Kawata, Chieko| Akashi, Hiroko| Shibata, Teruko| Umejima, Reiko| Fujikata, Keiko| Katayama, Naoko| Murakami, Junko|
Abstract ヘルスプロモーションの理念にそって,住民組織,行政,研究グループが協働して,住民の生活の質の向上をめざした地域保健活動の展開を計画した。まず,休眠状態にあった岡山県M町の健康づくり推進協議会(以下M町協議会と略す)を活性化するため,協議会の委員18人を対象に聴き取り調査を行い,次に,M町協議会でのディスカッションを深めた。1.M町協議会構成団体のうち住民組織は9組織で,このうち6組織は居住地域内の住民の推薦や輪番で代表を選出しており,他の3組織は任意であった。8組織の事務局は行政機関内にあり,活動経費の公費補助率は70%以上であった。2.委員の描く理想の町のイメージとして,福祉の充実した町で老後も安心できるという内容を含んだ回答が多かった。それを実現する為に,住民一人一人が自己管理意識を持つと同時に,協議会が支援的な活動を身近なところで展開することの必要性が挙げられた。3.M町協議会活動への委員の期待は大きく,協議会内での委員間の意思疎通も次第に深められた。事前に聴き取り調査を行ったこと等が効果的に影響したと考えられた。
Abstract Alternative Along with the idea of health promotion, we planned the community health activities to improve the quality of inhabitants' life in cooperation with inhabitants, community organizations, local government and health professionals. In order to revitalize an inactive committee for health promotion of M town hearing surveys were conducted on the members of the committee. 1. Leaders of community organizations occupied 9 of 19 members of the committee. Leaders of 6 organizations out of 9 ones were decided by recommendation or rotation. Eight secretariats of those organizations were located in the governmental office. Seventy percent or more of activity costs of these organizations depends on assistance of local government. 2. Members of the committee imaged the town, which was healthy and filled with mind of welfare as an ideal town. They pointed out that it was required for the committee to perform support activities to realize an ideal town as well as for every inhabitant to have the consciousness of self-management. 3. Activities of the committee were much expected by members of the committee. Communications between members deepened gradually by repeating the meetings. Hearing survey on members also seemed to be much effective for those progress.
Keywords 住民参加 (inhabitant participation) ヘルスプロモーション (health promotion) 健康づくり推進協議会 (a town committee for health promotion) 生活の質 (quality of life)
Publication Title 岡山大学医学部保健学科紀要
Published Date 2000-11-16
Volume volume11
Issue issue1
Start Page 41
End Page 48
ISSN 1345-0948
language 日本語
File Version publisher
NAID 120002313515
JaLCDOI 10.18926/11696
Title Alternative Thermological study on the coldness in women
FullText URL 061_046_054.pdf
Author Takatori, Akimasa| Okuda, Hiroyuki| Sekiba, Kaoru| Tanizaki, Yosiro|
Abstract サーモグラフィを用いた冷え症の診断基準を作ることを目的として,冷え症患者(30名)の体表面温度分布を体表面を11カ所に分けて中間温環境下でサーモトレーサ6T66を1用いて測定し,対称群(11名)と比較した。同時にCMI調査と,患者の日常生活に関するアンケート調査を実施した。その結果1.冷え症群では四肢末端部,ことに手掌・足背・足底において最低温度が低く,局所の最高・最低温度間の温度較差が大きい傾向を示した。軀幹部では最高温度,最低温度,温度較差すべて両群間に大きな差はみられなかった。2.冷え症群の手掌,足背,足底の温度分布パターンは末端部ほど温度が低いという特徴的なパターンを多く示した。3.CMI調査では,冷え症群の中等症と軽症例の一部に強い神経症的傾向を認めたが,重症例では神経症的傾向は軽度であった。4.アンケート調査では脂っこいものよりあっさりしたものを好きであるとか,顔にのぼせを感じることがある,甘いものが好きであるという例が冷え症群に多かった。以上の結果からサーモグラフィを用いて中間温環境下で四肢末端の温度鈴布を測定することにより,冷え症を客観的に診断する可能性を得た。
Abstract Alternative Whole body surface temparature was measured in 41 women with a thermtracer 6T66. Except palm, sole and instep, there were no differences in surface temperature of other parts of the body among these cases. Surface temperature of palm, sole and instep were lower than other parts of the body and showed 4 characteristic distribution patterns on thermography. Thermography at palm, sole and instep is useful for the objective approach of the patients who complain of coldness in some part of their bodies.
Keywords 婦人の冷え症 (Coidness in women) サーモグラフィ (Thermography)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 46
End Page 54
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313877
JaLCDOI 10.18926/11695
Title Alternative Antithrombogenic therapy after heart valve replacement - Effect of anti-platelet drug on aggregation-
FullText URL 061_055_060.pdf
Author Soda, Mitsuhiro| Yorozu, Hidenori| Suzuka, Ichio| Morisue, Shinhachi| Hirai, Shunnichi| Komoto, Yoshiaki| Kajitani, Nobuaki| Yoshizane, Ken| Naniwa, Hiroyuki| Kojo, Masayoshi| Teramoto, Shigeru|
Abstract 人工弁置換患者の血栓塞栓症(TE)は,長期予後の成績を左右する。 TEを減少させるために凝固因子を抑制するwarfarinと抗血小板剤による抗血栓療法が行われている。人工弁置換患者103例を対象に,抗血小板剤であるtrapidil(TP)とdipyridamole(DP)の血小板凝集能に与える効果を検討した。36ヵ月間検討したが,warfarin単独群は血小板凝集能に変化がなく,TP,DP共にADP凝集能を抑制した。しかし有意差の見られたのは全経過ではなく,凝集能抑制は強力かつ持続的ではなかった。またコラーゲン誘導凝集能は変化を認めなかった。TPとDPの抗血小板効果は同等と思われる。期間中の血栓塞栓発生は,warfarin単独群9.5%,TP群4.3%,DP群7.7%であった。臨床的に抗血小板剤の併用は有効と思われるが,血小板凝集抑制には投与量の増量,あるいは他の薬剤の検討が必要であろう。
Abstract Alternative To evaluate the effect of anti-thrombotic thrapy after valve replacement, serial platelet aggregation measurememnts were carried out in 103 patients. Patients were divided into three groups. e. i. warfarin alone (control), warfarin with trapidil (TP) of 300mg/day and dipyridamole (DP) of 300mg/day. The aggregation of platelet of the control group did not change through 36 months. TP group showed a decrease in platelet aggregation at 24 and 30 months from the pretreatment value. The aggregation of 24 month in TP was significantly lower than that of control. There was no difference of platelet aggregation between TP and DP group. The incidence of thromboembolism of control, TP and DP group were 9.5%, 4.3% and 7.7%, respectively. These data suggest that the supression of platelet aggregation .by TP and DP is not adequate to continue for long time and TP has similar anti-thrombotic effect to DP.
Keywords 人工弁置換術 (Heart valve replacement) 血栓塞栓症 (Thromboembolism) 血小板凝集 (Platelet aggregation) 抗血小板剤 (Anti-thrombotic drug)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 55
End Page 60
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313443
JaLCDOI 10.18926/11693
Title Alternative Hyhrid vascular grafts and one of our approaches
FullText URL 061_114_122.pdf
Author Noishiki, Yasuharu|
Abstract 人工血管により高度な機能をもたす目的で,ハイブリット化が今日進められるようになってきた。この背景について説明するとともに,我々の独自に行っているハイブリット型人工血管作成の方法およびその成果について報告する。その具体的方法としては以下の通りである。末梢静脈小片を勇刀にて細切したのち,約20ccの生理的食塩水に入れて静脈組織細切片浮遊液を作った。次に高有孔性人工血管の一端より吸引管を挿入し,これを作成した液に入れ,吸引によって組織片を外側から人工血管壁に絡ませた。次に新鮮な血液を注ぎ,組織片をさらに固着させた。成犬胸部下行大動脈へこのような処理をしたポリエステル布製人工血管を植え込んだところ,植え込み5日目に新生血管壁内部に無数の内皮細胞の増殖像がみられ,35日目の例では吻合部はもとより,人工血管の中央部ですら内皮細胞による完全な被覆を認めた。  以上のような方法で新生血管壁が容易に形成されることが判明したことより,今後,他の人工臓器分野でもハイブリット化が予測される。
Abstract Alternative Recently, vascular grafts had contributed in the treatments of various vascular disease, and today, was required to have fine functions like native blood vessels. Many kinds of approaches to develop the ideal graft had been applied. In these efforts, endothelial cells seeding technique to fabric vascular prostheses was reported successfully, however, it was not for general use. To get and proliferate the endothelial cells, special techniques and facilities were required. Moreover, it was not available for emergency use, smce the cell culture needed a certain period of time. To overcome these problems, we developed a reliable method to make a hybrid vascular graft as follows. Tissue fragments suspension was prepared using a piece of peripheral vein. Highly porous fabric vascular prosthesis was immersed into the suspension fluid. The tissue fragments were trapped from the outer surface of the prosthesis by intraluminal suction. Preclotting procedure was adopted to immobilize the tissue fragments to the fabric of the prosthesis. The prostheses were implanted into the thoracic descending aortae of 15 dogs. There was no bleeding at the time of the implantation. Numerous endothelial cells proliferation was observed in the specimen for 5 days after implantation. The surface was covered with thin layer of fibrin. Full endothelialization was noticed in the specimens of 35 days. The graft wall was completely healed. This method was very simple and easy to prepare, but the efficacy to promote the healing of the neointima was excellent.
Keywords 人工血管 (Vascular graft) ハイブリット (Hybrid) 新生内膜 (Neointima) 内皮細胞 (Endothelial cell) 自家移植 (Autologous transplantation)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 114
End Page 122
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313776
JaLCDOI 10.18926/11692
Title Alternative Stress coping pattern among pre-operative patients and relations to their background
FullText URL 011_2_049_057.pdf
Author Mizuhara, Midori| Watanabe, Kumi| Mochida, Sachiko| Ozaki, Yasuko| Okamura, Kyouko| Nishimura, Misae| Yoshizawa, Kiou| Takashima, Miyabi| Yamada, Kazuaki|
Abstract 術前訪問のストレス状態を軽減するための一手段として,手術室の看護者により術前訪問が行われている。患者自身のストレスの状態とその対処法が異なっていることは従来の研究より明らかであるが,このような個々の術前患者の対処状況に応じた術前訪問については,充分に行えていないのが現状である。患者のストレス状態は患者背景と関係しており,さらにはその対処行為をパターン化できるものと考え,この対処行為のパターンと,背景因子との関わりを明らかにし,それらを考慮した術前訪問のあり方を考えることを目的として本研究を行った。対象は1週間以内に手術予定の患者20名とした。データは面接による半構成的な質問に対する対象者の自由な回答を記録して収集した。質問内容は,1.対象者の背景要因としての「経験」「自己認知」「環境要因」2.対象者の心理状態・ストレス認知・対処について,「病気を発見した時」、「入院の必要性の説明を受けた時」「手術の必要性の説明を受けた時」「現在」の4つの時点についての心理状態,ストレスの認知,対処法について回想法によるものとした。対象者は男性11名,女性9名で,平均年齢は57.7±15.9歳であった。各事例における4時点での対処行為をパターン化したところ,A :「積極的対処」B:「回避」C:「おまかせ」D:「積極的対処」→「おまかせ」E:「回避」→「積極的対処」F:「回避」→「積極的対処」→「おまかせ」G:「回避」→「おまかせ」の7パターンに分類された。患者背景要因と対処法の関係については,次の2点が明らかとなった。1)ストレス対処に「問題状況の再認知」または「おまかせ」を用いていた患者は,癌告知を受けており,ストレス状態の軽減傾向が特徴的であった。それに対して,「回避」を主に用いていた患者は,未告知事例や疾患について曖昧な解釈の事例が集中しており,ストレス状態が特徴的であった。2)性格を「神経質」「辛抱強い」と自己評価した患者の対処行為として,「積極的対処」が共通して用いられていた。
Abstract Alternative Operating room nurses visit the pre-operating patients before the operation. This visit is designed to inform the patients and reduce their stress. But the stress level of each patient and their ability for dealing with stress may vary. The purpose of this study is to investigate stress-coping patterns of pre-operative patients. Twenty patients at the University Hospital of Chugoku Region in Japan volunteered for this study. Subjects consisted of 11 males and 9 females with average of 57.7 years old. An interviewer obtained data using an original semi-structured questionnaire after getting informed consent. Items of questionnaire were patient's background, his/her psychological status, stress recognition. The patients' coping mechanisms were evaluated using the recollection method at 4 different time points: a) when the patient's disease was diagnosed, b) when the patient was informed of the need for hospitalization, c) when the patient was informed of the need for operation, and d) at the time of the operation. We found common patterns of coping among them, which were classified into 7 categories: A) positive action at any situations, B) evasion, C) leaving, D) positive action and leaving, E) evasion and positive action, F) evasion, positive action and leaving, G) evasion and leaving. The following 2 points were noted between the patients' background and coping mechanisms: 1) Patients using "re-acknowledgment or leaving" pattern were informed well about their disease and did not feel stress from their situation. 2) Patients taking positive actions recognized their character as "nervous about their situation" or "patient".
Keywords 対処 (coping) 手術 (operation) 術前 (preoperation) 患者 (patient) ストレス対処パターン (stress coping pattern)
Publication Title 岡山大学医学部保健学科紀要
Published Date 2001-03-24
Volume volume11
Issue issue2
Start Page 49
End Page 57
ISSN 1345-0948
language 日本語
File Version publisher
NAID 120002313667
JaLCDOI 10.18926/11691
Title Alternative Clinical significance of eosinophilic leucocytes in onset mechanisms of bronchial asthma
FullText URL 061_089_097.pdf
Author Tanizaki, Yoshiro| Sudo, Michiyasu| Kitani, Hikaru| Kawauchi, Kazuhisa| Mifune, Takashi| Tada, Shinya| Takahashi, Kiyoshi| Kimura, Ikuro|
Abstract 末梢血好酸球が気管支喘息の発症病態にどのように関与しているかについて,1.末梢血好酸球の変動,2.好酸球の局所出現,3,好酸球とアレルギー反応,4.アレルギー反応と好酸球の機能,5.好酸球と喘息の臨床病態の各項目で検討した。その結果,気管支喘息では,全般的に末梢血好酸球増多がみられ,同時にアレルギー反応局所への遊走が観察されること,末梢気 道では,ある程度肺胞マクロファージの出現と逆相関にあること,リンパ球との関連もある程度認められることなどが示された。そして,局所出現した好酸球は,IgE抗体の関与の程度により,その機能が異なる可能性が示唆された。また臨床病型別の検討では,アトピー型ではいずれの臨床山型においても好酸球の出現率は明かな増加傾向を示したが,非アトピー型では,Ib.気管支攣縮+過分二型においてのみ好酸球増多が著明であった。
Abstract Alternative Participation of eosinophil leucocytes in onset mechanisms of bronchial asthma was discussed in following sections ; 1. changes in number of eosinophils in the peripheral blood, 2. emergence of eosinophils in local allergic reaction sites, 3. eosinophils and allergic reactions, 4. different functions of eosinophils III allergic reactions, 5. eosinophils and clinical types of bronchial asthma. The results showed that eosinophilia in the peripheral blood was generally observed in patients with bronchial asthma. In these cases, eosinophils migrated into local allergic reaction sites. A reversed correlation was present between number of eosinophils and macrophages, and number of eosinophils correlated to a certain extent with number of lymphocytes in the small airways and alveolar region. Function of eosinophils was shown to be different between IgE-and non-IgE-mediated reactions, by measurement of arylsulfatase activity III BALF. Marked eosinophilia in BALF was observed in any clinical types of atopic asthma, although eosinophils were increased only in bronchoconstriction + hypersecretion type (type II) of non-atopic asthma.
Keywords 好酸球 (Eosinophils) 肺生検 (Lung biopsy) 気管支肺胞洗浄 (Bronchoalveolar lavage) 臨床病型 (Clinical type) 気管支喘息 (Bronchial asthma)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 89
End Page 97
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313427
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 10.18926/11687
Title Alternative New trend of the development of vascular prostheses
FullText URL 061_098_113.pdf
Author Noishiki, Yasuharu|
Abstract 人工血管の開発研究における動向について,我々の行ってきた研究をまじえて世界の動きを解析した。近年の砺究の流れは過去1世紀にわたる試行錯誤の上にあって,さらに大きく揺れ動いている。人工血管の内面に必要な抗血栓性の獲得においても,設計者によって考えを異にし,米国では,人工心臓に用いる抗血栓性合性高分子材料をもってそれに当てようとしているものが多い。我々はあくまで宿主のもつ諸機能を引き出し,自然の動きの一つとしての治癒を無理なく導いて,内皮細胞によって内面を覆わせる方法を採用している。そのいくつかの例として,超極細ポリエステル繊維製人工血管,結合組織管,バイオマトリックス人工血管,ヘパリン化生体組織由来人工血管,成長できる人工血管などについて解説した。
Abstract Alternative Vascular prostheses have been used in the treatments of various vascular diseases. We expect much from their contribution in the field of further fine vascular surgery. In this communication, new trend of the development of them with our new ideas in our recent research works were described. 1. Healing process of fabric vascular prostheses. Neointima formation of the vascular prosthesis implanted in the descending thoracic aortae of experimental animals were described in detail. This showed a standard behaviour of various cells which contributed the construction of a new arterial wall. 2. Problems of vascular prostheses which were used in clinic. Several problems such as a bleeding from the graft wall, aneurysmal dilatation, and degenerative changes of the neointimae were explained in detail. These problems were related with the structure of each vascular prosthesis. 3. Vascular prostheses developing with new ideas. Several vascular prostheses developing today were described as follows. (a) Fabric prosthesis with high healing ability. A prosthesis made of ultra-fine polyester fibers which can accerelate cell migration and proliferation inside the prosthetic wall was introduced. The neointima in this prosthesis was constructed very rapidly compared with that of the prostheses made of polyester fiber ordinally used. (b) Antithrombogenic small diameter vascular prostheses. Large caliber vascular prostheses have been used very safely in clinic, however, small diameter ones were seldom used due to its low patency rate by their occlusion. The grafts should have an antithrombogenic property to prevent the thrombus formation. Recently, some technologies to give antithrombogenic property to the vascular prostheses were developed. They were a heparin slow release technique, antithrombogenic segmented polyurethane, highly hydrous surface, heparinized collagen tube, etc. They were applied for the development of small diameter vascular grafts and showed good results in some animal experiments. (c) Growable vascular graft. A vascular graft which can grow with the growth of its recipient baby was demonstrated. The animal study showed as expected growth and stop growing at the expected time. (d) Vascular graft for aorto-coronary bypass surgery. A small diameter antithrombogenic, and flexible vascular grafts were explained. They were developed along our own ideas. This showed high patency rate m animal experiments. (e)Endothelial cell seeding techniques. In human, endothelialization m the vascular grafts is delayed and the inner surface was thrombogenic for a long period of time. To accerelate the endothelialization, cell seeding technique have been investigated in the last decade. We developed a new technology to transplant autologous cells in the peripheral vein tissue for this purpose. This was very reliable and simple. It was applicable in any hospital without any special technique and facility. Peripheral venous tissue fragments were transplanted into the fabric vascular prosthetic wall. Endothelial cells and smooth muscle cells migrated and proliferated from the tissue fragments. The neointima was constructed very rapidly with this active cell migrations.
Keywords 人工血管 (Vascular prosthesis) 新生内膜 (Neointima) 内皮細胞 (Endothelial cells) 抗血栓性 (Antithrombogenicity)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 98
End Page 113
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313859
Author Obata, Takayoshi|
Published Date 2007-03-31
Publication Title 文化共生学研究
Volume volume6
Issue issue1
Content Type Departmental Bulletin Paper
JaLCDOI 10.18926/12844
JaLCDOI 10.18926/11685
Title Alternative 日本に於ける二酸化炭素泉療法の現況
FullText URL 061_068_072.pdf
Author Komoto, Yoshiaki| Soda, Mitsuhiro| Hirai, Shunichi| Morisue, Shinhachi| Suzuka, Ichio| Yorozu, Hidenori|
Abstract Natural CO(2) springs have been scarcely utilized in Japan, whereas artificial CO(2) bathing has become popular by the introduction of CO(2) tablets and other apparatus for CO(2) water supply. Artificial CO(2) bathing is indicated for degenerative connective tissue disorders such as scleroderma, common stiff and painful shoulders, chronic joint pain, lumbago, and trophic changes due to insufficient peripheral circulation by virtue of the increase of tissue pO(2) and the improvement of tissue perfusion. Artificial CO(2) bathing promotes recovery from fatigue and is beneficial in women whose health has been adversely affected by cold.
Abstract Alternative 日本では,天然の二酸化炭素泉は殆ど利用されていない。一方,CO(2)錠剤,CO(2)給水装置が開発されて人工二酸化炭素泉がよく用いられるようになってきた。皮下組織の酸素分圧の上昇と組織循環の改善という好ましい生理作用により,結合織の退行性変化による慢性障害,すなわち強皮症,関節症,慢性関節痛,腰痛症,および末梢循環障害に伴う組織の栄養障害に適応がある。また,疲労回復を促進し,いわゆる冷え症に好ましく作用する。
Keywords CO(2) -balneotherapy Artificial CO(2) -bathing Tissue pO(2)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 68
End Page 72
ISSN 0913-3771
language 英語
File Version publisher
NAID 120002313982
JaLCDOI 10.18926/11683
Title Alternative The reality investigation of stresses which the new figure nurses employed after one month hold
FullText URL 011_2_071_076.pdf
Author Mori, Keiko|
Abstract 看護教育カリキュラムの改正により,臨床での実習時間はますます減る傾向にある。一方,臨床現場では,医療の高度化,複雑化が進み,看護基礎教育と現場のギャップは大きくなる傾向にある。今回38名の新人看護婦にアンケート調査を行い,新人看護婦の抱えるストレスについて明らかにした。その結果,新人看護婦の抱えるストレスは,看護技術に関するストレスが最も多く(94%),ついで,3交代勤務による不規則な生活(14%),患者とのコミュニケーション(11%)であった。この結果には教育課程の違いによる差は認められなかった。多くのストレスの中で働く新人看護婦は,32.3%が,体調についてあまりよくない,あるいは良くないと回答していた。また,様々なストレスにより,就職後1ヶ月で退職を考えているものが6名(17.6%)いた。看護婦になってよかったと答えたものは8名(82%)あり,その多くが,患者との関わりがうまくいったときにそのように感じていた。新人看護婦が,今後の看護基礎教育に望むことは,技術面の体験をさらに増やすこと,移植医療,ME機器の取り扱いなどであった。
Abstract Alternative Revision of curriculum makes reduce the practice time in clinical more and more. On the other hand, in clinical site, the gap between the nursing base education and the clinical site shows the tendency to enlarge because of high-developed medicine and complicated situation. This time, I put into practice the questionnaire survey for 38 new figure nurses to make their having stresses clear. Consequently, they expressed mainly three causes of their stress. They were about the nursing skills (94%), irregular life due to three shifts (14%) and the way of the communication to the patient. There weren't any differences among each nursing curriculum. 32.3% of the new figure nurses having much stresses said about their physical condition that they were not good or not so good. The 6 new figure nurses (17.6%) thought that they wanted to quit their job only one month after being nurse. The 8 new figure nurses (82%) thought that they were satisfied with being nurse. When many new figure nurses could make good communication with their patients, they thought that. The new figure nurses said that they wanted to study about more nursing skills, medicine of transplantation and ME equipments.
Keywords 新人看護婦 (The new figure nurse) ストレス (stress) リアリティーショック (reality shock)
Publication Title 岡山大学医学部保健学科紀要
Published Date 2001-03-24
Volume volume11
Issue issue2
Start Page 71
End Page 76
ISSN 1345-0948
language 日本語
File Version publisher
NAID 120002313522
JaLCDOI 10.18926/11679
Title Alternative Clinical evaluation of new formula included oligopetide as a nitrogen source in surgical patients
Author Soda, Mitsuhiro| Yorozu, Hidenori| Morisue, Sinhachi| Hirai, Shunichi| Suzuka, lchio| Komoto, Yoshiaki| Kajitani, Nobuaki| Yoshizane, Ken| Naniwa, Hiroyuki| Teramoto, Shigeru|
Abstract 窒素源としてdi-,tri-peptideを含有した経腸栄養剤を外科患者に使用した。.この新しい経腸栄養剤は卵白を加水分解したもので,70%がoligopeptideであり,アミノ酸も10%含まれる。糖質はデキストリンで,脂肪の含有量は少なく浸透圧はエレメンタルダイエット(ED)より低い。この製剤を安定期および術後に使用した。アルブミン,rapid turnover proteinの回復がみられ,臓器蛋白の合成が得られた。術後例では3メチルヒスチジンの排泄量は減少せず,異化反応は抑制されなかった。投与量の不足が一つの原因と思われる。副作用の下痢はほとんどみられず,栄養改善効果もあり,有用性が認められた。
Abstract Alternative The clinical usefulness of new enteral formula which is contained di-and tri-peptides as a nitrogen source was evaluated in surgical patients. The enteral nutrition was introduced to stable patients who could not take food orally and postoperative ones who were undertaken upper GI surgery. Adverse effects such as diarrhea or abdomonal distension were not observed. V isceral proteins were improved after administration of this regimen and nutritional status was maintained in all patients. However, high urinary excretion of 3methylhistidine continued in great extent during postopertive period and breakdown of skeletal muscle was not prevented by this nutritional therapy. This might be due to insufficient intake of energy and nitrogen. This new product for enteral nutrition would be safe and useful as enteral nutrition.
Keywords 経腸栄養 (Enteral nutrition) エレメンタルダイエット (Elemental diet) オリゴペプチド (Oligopeptide) 外科栄養 (Surgical nutrition)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 61
End Page 67
ISSN 0913-3771
language 日本語
File Version publisher
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 10.18926/11672
Title Alternative A case of malignant lymphoma of the small intestine
FullText URL 061_134_137.pdf
Author Hirai, Shunichi| Suzuka, Ichio| Morisue, Shinhachi| Soda, Mitsuhiro| Komoto, Yoshiaki| Yorozu, Hidenori|
Abstract 原発性小腸悪性リンパ腫は,術前診断が困難で予後が悪い,比較的希な疾患である。我我の症例は60歳の男性で,右下腹部痛にて来院し,急性虫垂炎の診断で手術を施行した。手術時,回腸末端部より10cm口側に潰瘍性病変を認め,クローン病を疑って回盲部切除を施行した。病理組織検査にて悪性リンパ腫,difuse,medium sized cell typeと診断され,広範回腸切除を含む右記結腸切除及び所属リンパ節郭清を行った。リンパ節転移は認めず,stage I,治癒切除と考えられた。術後7カ月現在,再発の徴候無く外来通院中である。本症は5年生存率22~40%と茅後の悪い疾患であるが,stage I・IIとstage III・IV,治癒切除と非治癒切除の生存率には明かな差があり,早期の診断と根治切除の重要性を示唆している。また本症は,緊急手術を要する場合や自験例のごとく急性虫垂炎の診断で手術を受けることが少なからずあると思われ,根治切除に確信のもてない場合は再手術をためらってはならないと考える。
Abstract Alternative A 60 - year-old man complaining of right lower abdominal pain was sent to the operating room for acute appendicitis. The ileocoecal resection was performed for ulceration of the terminal ileum, which was diagnosed as an intestinal malignant lymphoma histologically. The case, therefore, was re-operated three weeks after the first operation. The right half of colon, and about 70 centimeters of ileum with their regional lymphnodes were resected. The case was revealed as the first stage of clinical classification by Naqvi et al. Up to the present time, 7 months after the first operation, there were no sIgns of reccurence. Intestinal malignant lymphoma somtimes has need to do an emergency oparation, and reoperation should be done without hesitation, if necessary.
Keywords 小腸悪性リンパ腫 (Malignant lymphoma of the small intestine) 小腸悪性腫瘍 (Malignant tumor of the small intestine)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 134
End Page 137
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313492
JaLCDOI 10.18926/11670
Title Alternative A case of atopic asthma characterized by marked neutrophilia in BALF
FullText URL 061_129_133.pdf
Author Kawauchi, Kazuhisa| Mifune, Takashi| Kitani, Hikaru| Sudo, Michiyasu| Tanizaki, Yoshirou| Kataoka, Hisakazu| Tada, Shinya| Takahashi, Kiyoshi| Kimura, Ikuro|
Abstract 気管支肺胞洗浄液(BALF)中に高度の好中球の増多が見られ,治療により臨床症状の軽快と共にBALF中の好中球の減少を認めたアトピー型喘息の一例を経験した。経過中5回施行したBALF中の好中球百分率はそれぞれ65.4%,56.2%,42.4%,5.6%,5.6%であり,4回目,5回目では著明な好中球減少を認めた。本症例の如き症例は今後増加することが予想され,その発症病態を含め今後さらに症例を重ねて検討して行く必要があると 考えられた。
Abstract Alternative The clinical course and characteristics of a case with atopic asthma, showing marked neutrophilia in BALF and severe asthma attacks, were observed the frequency of neutrophils in BALF decreased followed by the improvement of her asthma attacks with therapy. The frequency of neutrophils in BALF was 65.4% at the initial stage before the therapy and decreased to 5.6% at attackfree stage after the therapy. The changes in frequency of neutrophils in BALF, obserbed in this case, should be noticed, because the cell in BALF were hardly affected by any treatment.
Keywords アトピー型喘息 (Atopic asthma) 好中球 (Neutrophil) 気管支肺胞洗浄法 (Bronchoaiveolar lavage)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 129
End Page 133
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313690
JaLCDOI 10.18926/11669
Title Alternative A case report of appendiceal calculus presented as abdominal tumor
FullText URL 061_138_142.pdf
Author Suzuka, Ichio| Hirai, Shunichi| Morisue, Shinhachi| Soda, Mitsuhiro| Komoto, Yoshiaki| Yorozu, Hidenori|
Abstract 虫垂結石は虫垂炎手術例の数%に見られるに過ぎないが,穿孔性腹膜炎などの重篤な炎症を招く可能性が高いことで知られている。自験例は41才の女性で,右下腹部腫瘤を主訴として来院した。画像診断で腫瘤は虫垂に連続し,内部に石灰化を認めたが,腫瘤が硬く,虫垂炎症状が軽微であったことから,虫垂原発腫瘍を疑い手術を行ったところ,虫垂膿瘍を併発した虫垂結石であった。本症が自験例のように触知可能な腹部腫瘤を形成することは比較的まれである。
Abstract Alternative Appendiceal calculi are found in the only several percent of patients with appendicitis and have been known to be complicated in severe appendicitis or perforated peritonitis. We reported a 41-year-old female patient, whose initial symptom was right lower abdominal tumor of insidious growing. Abdominal examination revealed a small fist sized hard mass in the right lower abdomen with slight tenderness, and free of rebound tenderness and muscle defence. Abdominal ultrasonography and computed tomography showed that the tumor had continuity with appendix and contained calcification inside. Accordingly, she was diagnosed to have an appendiceal neoplasm and operated on. Post-operative diagnosis was appendiceal abscess with a calculus, 1 centimeter in diameter. It is rare that appendiceal calculi manifest a palpable abdominal tumor like this case.
Keywords 虫垂結石 (Appendiceal calculus) 腹部腫瘤 (Abdominal tumor) 急性虫垂炎 (Acute appendicitis)
Publication Title 環境病態研報告
Published Date 1990-09
Volume volume61
Start Page 138
End Page 142
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002314032
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 10.18926/11664
Title Alternative A dietary survey in patients with chronic pancreatitis
FullText URL 062_011_015.pdf
Author Hayashimoto, Kanae| Ochi, Koji| Harada, Hideo| Tanaka, Juntaro| Takuma, Masae| Masui, Etsuko| Tanizaki, Yoshiro| Matsumoto, Shuji| Seno, Toshinobu| Izushi, Michihiro|
Abstract 食事療法は慢性膵炎治療の基本として重要であるが,その具体的な内容についてはあまり明確にされていない。今回,筆者らは慢性膵炎例の食事に関する全国調査の一部を担当したので,その成績を報告し,問題点と対策について考察した。対象は慢性膵炎間欠期の患者56名(男44名,女12名)である。(1)エネルギー摂取量では1日1,400kcal以下が16名(29%)にみられ,肥満度80~90%が7名および80%以下が9名という栄養状態と考え合わせて,食事の回数を増やしてでも摂取エネルギーの改善をはかる必要がある。(2)蛋白質および脂質摂取量についても同様な成績であり,消化酵素剤を投与しながら量的,質的な改善をはかる必要がある。(3)糖質については質的改善をはかる必要がある。(4)ビタミンとミネラルも不足傾向にあった。野菜の摂取不足が顕著であった。(5)診断確定後も禁酒できない患者が男17名(39%),女1名(8%)にみられ,その指導が重要な課題である。
Abstract Alternative Importance of diet therapy has been emphasized in chronic pancreatitis. However, concrete measures and programs of the diet therapy have remained to be studied. Therefore, Intractable Pancreatic Disease Study Group recently carried out a nation-wide questionnaire survey on the diets in patients with chronic pancreatitis under the auspIces of the Ministry of Health and Welfare. Attendant physicians were requested to report the nutritional states of their patients and the kinds and amounts of foods taken by their patients on three consecutive days. The nutritional state was evaluated by a body weight index calculated by the following formula:Body Weight Index (%) = Present Body Weight / Ideal Body Weight X 100. Daily nutritional intake (calorie, protein, fat, carbohydrate, and others) was calculated by dieticians according to the Food Exchange Table published by the Japanese Association of Diabetes. The present study constitutes a part of the group study. Patients consisted of 44 men and 12 women who fulfilled the diagnostic criteria proposed by the Japanese Society of Gastroenterology;20 men and 3 women had secondary diabetes mellitus. Following results and conclusions were obtained. (1) Average daily calorie intake of the patients was 1,759kcal as compared with 2,057kcal in the general population in Japan. Sixteen patients (28.6%) showed daily calorie intake less than 1,400 kcal and consequently poor nutritional states (6 patients with body weight indices less than 80% and 10 with 80-90%). It is important, therefore, to try to improve the daily calorie intake by increasing the frequency of diets in these patients. (2) Average daily intake of protein was 72.1 g (animal protein 38.1 g), only slightly less than 79.2 g (animal protein 41.7 g) in the general population. However, as many as 16 patients (28.6%) showed daily protein intake of less than 60 g and poor nutritional states as described above. It is important, therfore, to encourage patients to maintain the daily protein intake of more than 60 g by increasing the frequency of diets with oral administration of digestive enzymes. (3) Average daily intake of fat was 39.9 g (animal fat 23.8 g), approximately 20 g less than 58.3 g (animal fat 28.0 g) in the general population. As many as 17 patients (30.4%) showed daily fat intake of less than 30 g , and 16 of the 17 patients showed poor nutritional states as described above. It is important, therefore, to encourage patients to maintain the daily fat intake of more than 30 g (especially by increasing the amounts of vegetable oil) by increasing the frequency of diets with oral administration of digestive enzymes. (4) Average daily intake of carbohydrate was 278 g, almost equal to 289 g in the general population. However, many patients took as much as 48 g of carbohydrate in the from of cakes, plain sugar and alcohol beverages. Seventeen men (39%) and one woman (8%) had continued drinking alcohol beverages even after the diagnosis was made. It is important, therefore, to encourage patients to improve the quality of carbohydrate intake, although it is admittedly difficult to realize the ideal. (5) Intake of vitamins and minerals (especially calcium) also tended to be insufficient. Green vegetables were especially insufficient. (6) In conclusion, it is utmost important in chronic pancreatitis to perform periodical evaluation of nutritional intake and feed back the information to the treatment through a close patient-dietician-doctor relationship.
Keywords 慢性膵炎 (Chronic pancreatitis) 食事療法 (Diet therapy in chronic pancreatitis) 栄養状態 (Nutrition in chronic pancreatitis)
Publication Title 環境病態研報告
Published Date 1991-08
Volume volume62
Start Page 11
End Page 15
ISSN 0913-3771
language 日本語
File Version publisher
NAID 120002313896