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Factors Associated with Blunt Cerebrovascular Injury in Patients with Cervical Spine Injury
No full text埼玉医科大学博士（医学）平成25年
Anti-Tumor Activity of Traditional Chinese Medicine, Ekki-Youketsu-Fusei-Zai, and Its Effects on Immunocyte Functions : 2.Induction of Morphological Changes of Murine Macrophage Cell Line J774.1 and Enhancement of Their IL-12 Production by Traditional Chinese Medicine, Ekki-Youketsu-Fusei-Zai
No full text中国の伝統的漢方薬である「益気養血扶正剤」（オウギ，ジュクジオウ，トウキ，ジュクシャ，タイソウ，ロクジョウの6種類から構成される：以下EYFZと略す）が抗腫瘍活性を示すことが担癌マウスの延命効果並びにNK活性促進から判明したので，本研究では第2としてマクロファージ機能への影響を知る目的で，同じBALB/c糸マウス由来のマクロファージ細胞株J774.1細胞を用いてEYFZの影響をIn vitro で追究した．J774.1の培養液に種種の濃度のEYFZを添加した，細胞形態の変化を細胞機能活性化の視点で経時的に顕微鏡観察するとともに，マクロファージ産生サイトカインであるインターロイキン-12（IL-12）並びに腫瘍壞死因子（TNF-α）の産生への影響をRT-PCR法及びELISA法によって調べた．実験の結果，EYFZを添加すると，非添加群よりも早く細胞の大きさが増し，球状タイプよりも伸展タイプの数が増加することが判明した．一方，RT-PCR法でサイトカインmRNA発現を調べると，特にIL-12p35及びIL-12p40がEYFZによって強く誘導された．またJ774.1の培養液中IL-12産生をELISA法で検討した結果，実際にIL-12がEYFZ存在下で強く産生されることがわかった．以上の結果から，EYFZにはマウスのマクロファージ細胞株J774.1の機能を活性化する作用があり，細胞性免疫機能を亢進することが強く示唆された．Ekki-Youketsu-Fusei-Zai (EYFZ), one of the Traditional Chinese Medicines (TCMs) is a mixture of six kinds of crude drugs. It was already found that an oral administration of EYFZ had a life-prolonging effect on tumor-bearing mice and an inhibitory influence on tumor growth. To elucidate the mechanisms of these anti-tumor effects, we first investigated the effect of EYFZ on morphology and cytokine production of murine macrophage-like cell line, J774.1 cells. In this experiment, the addition of EYFZ (1.2mg crude drug/ml) to J774.1 culture induced the morphological change from round type to spread type, also the increase of their size. We next examined 6 kinds of cytokine mRNA expression by J774.1 cell in response to EYFZ-stimulation. RT-PCR revealed that both interleukin-12 (IL-12)p35 and IL-12p40 mRNA expression were induced by EYFZ treatment. Moreover, EYFZ promoted the secretion of IL-12 from J774.1 cells. These results strongly suggest that EYFZ with some significant anti-tumor effect induces the functional activation of J774.1 cells
Effects of Traditional Chinese Medicine, Ekki-Youketsu-Fusei-Zai, on Human Peripheral Blood Lymphocytes In Vitro
No full text中国の伝統的漢方薬である「益気養血扶正剤」（オウギ，ジュクジオウ，トウキ，ジュクシャ，タイソウ，ロクジョウの6種類から構成される：以下EYFZと略す）が抗腫瘍活性を示すことを，担癌マウスの延命効果，NK活性促進並びにマクロファージ細胞株J774.1細胞機能活性化から明らかにしたので，本研究では特にヒトの末梢血中のリンパ球機能に着目し，In vitro で EYFZがリンパ球機能にいかなる影響を及ぼすかについて追究した．最初に，分離した末梢血中のリンパ球増殖に対する影響をMTTアッセイで調べた結果，EYFZはマイトーゲンが存在していない条件下でも著しくリンパ球の増殖を引き起こすことがわかった．さらに，リンパ球由来サイトカインであるインターロイキンー2（IL-2），IL-4及びインターフェロン-γ（IFN-γ）の産生に対するEYFZの影響をRT-PCR法並びにELISA法によって検討した．その結果，EYFZは特にINFγ-mRNAのみの誘導とIFN-γのみの産生を引き起こす効果のあることが判明した．このINFcがいかなる種類のリンパ球由来したものかを同定するために，抗CD4抗体と抗CD8抗体を用いて阻害実験を行った結果，これらの抗体によってINFcの産生は阻害されることがわかった．以上の結果から，EYFZにはヒト末梢血中のCD4＋あるいはCD8＋のTリンパ球を芽球化すると同時に，INFγの産生を促進してTh1優位を引き起こす結果細胞性免疫を高める効果のあることが強く示唆された．The effect of Traditional Chinese Medicine (TCM), Ekki-Youketsu-Fusei-Zai (EYFZ), on human peripheral blood lymphocytes (PBL) was investigated in vitro. MTT assay showed that EYFZ could directly stimulate PBL to proliferate without mitogen. In addition, RT-PCR and ELISA revealed that though EYFZ induced the expression of interferon gamma (INF-γ) mRNA and the production of INF-γ in culture supernatant, it did not induce the experssion or the production of interleukin-2 (IL-2) or interleukin-4 (IL-4). Moreover, we also examined which kind of immunocyte was involved in the INF-γ production by EYFZ in culture supernatant by inhibition experiment with monoclonal antibodies. It was shown that the EYFZ induced the production of INF-γ by T cell subsets of CD4＋and CD8＋cells. Thus, these results suggest that EYFZ has some significant stimulating effects on proliferation of PBL and the induction of INF-γ by T cells subsets in human
The Prognostic Significance asγ-Seminoprotein(γ-Sm) andγ-Sm /Prostate Specific Antigen (PSA) Ratio in the Prostate Cancer
No full textThe utility of PSA ratio (free/total PSA) in the diagnosis of early-stage prostate cancer is the primary focus of our current research into the interrelationships between various prostate cancer markers. In the present study I evaluated the clinical significance of cancer markers, namely prostate specific antigen (PSA) and gamma-seminoprotein (γ-Sm), as prognostic factors. Levels of PSA andγ-Sm were analyzed in 139 patients diagnosed with prostate cancer between January 1989 and December 1998. Levels of PSA andγ-Sm were measured using the enzyme immunoassay (EIA) method. The 139 patients were divided into two groups with respect to medians of each marker, andγ-Sm/PSA ratio. Differences in survival rates were then compared by the Kaplan-Meier method. Among high stage patients, PSA did not represent statistically significant prognostic factors. However, significant differences were observed inγ-Sm andγ-Sm/PSA ratios with regard to survival rates and relapse-free rates. As a result,γ-Sm/PSA ratio is useful not only as a diagnostic factor, but also as a prognostic factor
Blockade of Renin-Angiotensin System with Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blocker Improves Vascular Distensibility in Non-Diabetic Chronic Kidney Diseases
No full textWe examined the effects of angiotensin inhibition on pulse wave velocity (PWV) for the patients with non-diabetic kidney diseases. Patients were divided into 4 groups according to their renal function and medication. Patients were followed for a year, and PWV was annually measured. Age, heart rate and systolic blood pressure correlated to PWV (R2=0.58, p<0.0001). Regardless of medications, patients with normal kidney function showed well blood pressure control (130±1/72±1 to 129±2/73±2 mmHg, n=48) and no deterioration of renal function (Scr: 0.85±0.03 to 0.89±0.04 mg/dl), but only patients under angiotensin inhibition manifested a decrease in PWV (1914±84 to 1744±64 cm/sec, n=40, p<0.01). Although blood pressure was maintained below 130/80 mmHg in renal insufficiency patients, renal dysfunction progressed (2.21±0.11 to 2.75±0.18 mg/dl, p<0.01, n=43). With angiotensin inhibition, PWV decreased in this population (1703±64 to 1567±57 cm/sec, n=38, p<0.01). The present findings indicate that age, heart rate and systolic blood pressure constitute important determinants of PWV, and suggest that angiotensin blockade helps keep arterial distensibility in patients with chronic non-diabetic kidney diseases
Leukocyte Transmigration in JAM-B Disrupted Mice
No full textJunctional Adhesion Molecule (JAM)-B is known as one of the members of the immunogloblin super family and is involved in formation of tight junction of many types of cells including epithelial and endothelial cells. It has recently been demonstrated that, in response to inflammation, JAM-B present on the surface of endothelial cell forms heterophilic interactions with JAM-C on the leukocyte during transmigration from blood vessels into affected tissues. The formation of JAM-B－JAM-C complex strongly suggests that this heterophilic interaction plays an important role in the transmigration of the leukocytes. To address this question, I generated mice lacking JAM-B. Subsequently, I examined leukocyte transmigration in JAM-B－/－ mice by Contact Hyper Sensitivity (CHS) model using oxazolone as sensitizing agent and thioglycollate-induced peritonitis model. From these analyses, I found that levels of leukocyte transmigration in JAM-B－/－ mice were similar to those of wild-type mice. Thus, our results established that the gene is dispensable for this event
The left sided inferior vena cava (IVC) as an educational case study
No full textA case of a left sided inferior vena cava (IVC) along with other anatomical vessel variations in an 87-year-old Japanese male cadaver is reported.
The left sided IVC, which was formed by confluence of the common iliac veins behind the left common iliac artery at the level of the fifth lumbar vertebra, ascended vertically along the left side of the vertebral column and the abdominal aorta. It passed upward to receive a left testicular vein and two left renal veins which crossed. After receiving the left renal veins, the left sided IVC passed obliquely upward to the right of the vertebral column to receive the left suprarenal vein. At the right side of the abdominal aorta, the oblique part received the common stem of the second lumbar vein, which crossed behind the testicular artery, and a vein from paraaortic lymph nodes. Then, it received the right renal vein with the right testicular vein. The remainder of the caval pathway assumed its normal position to the right of the aorta. We consider that the above mentioned anomaly of the IVC is formed by the persistence of the left supracardinal vein and the disappearance of the right one. The present case belongs to Type 2 of the classification of Yoshida et al.(1981). In the present study, we discussed the formation of the anomalous variations and clinical symptoms
The effects of paramagnetic contrast media on choline peak in proton MR spectroscopy of the breast: a preliminary study
No full textAdministration of contrast media before proton magnetic resonance spectroscopy (1H MRS) may allow more accurate placement of the volume of interest in breast tumors, but some studies have suggested their use decreases the choline peak. We studied the impact of contrast use to determine which method would reduce the choline peak the least.
Phantoms containing 1, 5, and 10 mM concentrations of choline were prepared in phosphate-buffered saline and mixed with contrast media in concentrations of 0, 0.2, 0.4, and 0.6 mM. We used 2 different media: one being a negatively-charged diethylenetriaminepentaacetic acid gadolinium (Gd-DTPA), and the other a neutral gadoteridol (Gd-HP-DO3A). We studied all phantoms by single voxel 1H MRS with a repetition time (TR) of 2,000 msec and an echo time (TE) of 136 or 270 msec.
Gd-DTPA tended to induce an increase in the peak integral and amplitude at lower concentrations and a decrease at a higher concentration, whereas Gd-HP-DO3A tended to induce an increase in the peak integral and amplitude at lower concentrations with no definite decrease at higher concentrations. Neither contrast medium induced a definite change in peak width. The reduction of the choline peak integral and amplitude at TE of 270 msec was greater than at TE of 136 msec.
Therefore, we recommend the use of the neutral contrast agent and short TE in 1H MRS studies of breast tumors to avoid underestimation of the level of choline peaks
A case of pancreatic cancer with pseudocyst successfully treated by EUS-guided drainage
Get PDFA 58-year-old man complaining of jaundice was diagnosed with advanced cancer in the head of the pancreas and pancreatic pseudocyst. After the placement of a 7Fr plastic biliary stent, endoscopic ultrasonography-guided pseudocyst drainage was successfully performed. The cytology of pseudocyst fluid was class V. The jaundice and abdominal pain improved. The patient underwent FOLFILINOX chemotherapy without major complaints. Here, we report a case of pancreatic pseudocyst associated with pancreatic cancer that was successfully treated with endoscopic pseudocyst drainage, and chemotherapy
A role and problem of the visit ing nurse in the local inclusion care system of Japan viewing from a French at-home hospitalizat ion system(HAD)．
No full text地域包括ケアシステムの構築には, 地域で生活を営むための生活視点を踏まえた医療への転換や医療・看護・介護・福祉の連携を含めた地域づくりが重要であると考える．フランスの在宅入院制度（HAD）では，多職種がチームとして連携し在宅医療（ケア）の推進に取り組み，地域で生活する療養者の生活を支え，適切な在宅医療（ケア）を提供している．フランスの医療制度は，日本の医療制度と類似する面が多い．2025 年に地域包括ケアシステムの実働を目指し，都道府県単位によるシステム構築が急速に進められている．厚生労働省内閣官房：地域医療構想の策定（2015）によると, およそ26 万床の療養病床を在宅医療へ移行することが挙げられている．また，日本看護協会の平成28 年度重点政策・重点事業（和田, 2016）の4 つの主軸において，先ず「地域包括ケアシステムの構築と推進」を挙げ，その内容として①看護がつなぐ地域包括ケアの推進，②在宅・施設等の長期療養者を支える看護の機能強化を明確にしている．フランスの医療制度，文化，国民性等が違うためフランスの在宅入院制度（HAD）における訪問看護師の役割と業務をそのまま，わが国の在宅看護における訪問看護師の役割として適用することは不可能であるが，訪問看護師の重層的な構造化が必要であり，それぞれの階層ごとに訪問看護師の役割と業務を明確にする必要がある．また，それぞれの階層に応じた訪問看護師に求められる能力を明確にする必要があると考える．
地域で生活する療養者の生活の質を維持し向上するためには, 看護職間で情報共有や看護ケアに関しシームレスに看護が提供できる仕組み作りが必要であり，看看連携システムの構築が重要であると考える．また，地域包括ケアシステムにおいて仕組みづくりと医療・看護・介護・福祉に携わる多職種との人づくりを含めた地域づくりを担う役割が訪問看護師に求められていると考える