湖沼生態系モデルによる西湖水質浄化対策効果の検討

Article信州大学理学部附属諏訪臨湖実験所報告 11: 109-122(1999)departmental bulletin pape

下顎大臼歯欠損症例における小臼歯歯周組織の応力と歪みの分析

The purpose of this study was to investigate the stress/strain distributions around the mandibular premolar teeth in patients with loss of molar support. Subjects included female patients with loss of bilateral mandibular molar teeth that were restored with removable dentures (n=7, age from 51 to 69) and controls with complete dentition (n=7, age from 50 to 68). Occlusal contacts and bite forces were recorded under the maximum clenching with and without denture wearing. Finite element model of the mandibular first and second premolar teeth, periodontal ligament and bone was constructed for each patient based on radiographs and study models. The bite forces were applied on corresponding locations in the models to calculate the stress/strain of the periodontium. The forces, the maximum strain and stress of the molar loss group ranged widely among subjects, but they were all significantly higher than those of control group (p<0.05), and they were not prevented by denture wearing. Three subjects demonstrated high compressive cortical bone strain exceeding the estimated threshold of micro-damage of bone. The results suggest that the periodontium of the most posteriorly-located occluding premolars may become sensitive to bilateral loss of molar support if patients exhibit higher maximum bite forces

カジョウ エンブン セッシュ ガ ジン キノウ テイカ オ テイスル イッパン ジュウミン ノ ケッチュウ Bガタ リニョウ ペプチド ニ オヨボス エイキョウ ノ ケントウ

Background: Both subtle elevation of B-type natriuretic peptide (BNP) and a decrease in estimated glomerular filtration ratio (eGFR) were reported to be related to the development of cardiovascular disease in apparently asymptomatic populations. However, the relationship between excess salt intake, eGFR and BNP in the general population remains to be determined.Methods and Results: This community-based cross sectional study enrolled individuals over 40 years old (n = 3115) in Takahata, Japan. There were 206 subjects with chronic kidney disease (CKD) (eGFR < 60 mL/min/1.73m2). Plasma BNP levels were higher in subjects with CKD than in those without CKD. However, subjects with CKD had a lower salt intake, higher systolic blood pressure and higher plasma renin activity (PRA) than subjects without CKD. There was a greater increase in BNP levels with salt intake in CKD subjects compared to those without CKD. PRA was significantly suppressed by excess salt intake in both groups. Multivariate analysis showed that salt intake was an independent risk factor for elevated BNP levels in CKD subjects, but not in those without CKD.Conclusions: Excess salt intake is an independent risk factor for elevated plasma BNP levels, especially in subjects with CKD. These results suggest that sodium restriction for prevention of future cardiovascular events may be more important in subjects with CKD than in those without CKD

ブンベン マジカ ニ シンダンサレ，ブンベンジ タイリョウ シュッケツ オ キタシタ キュウセイ ゼンコツズイキュウセイ ハッケツビョウ (APL) ガッペイ ニンシン

Acute promyelocytic leukemia（APL）occupies approximately about 10～15% of acute myeloblastic leukemia. After the introduction of all-trans retinoic acid（ATRA）therapy, the prognosis of APL has been dramatically improved. However, APL still remains life-threatening, because disseminated intravascular coagulation（DIC）occurs in large portions of patients with this disease. Here we report a case of the pregnant woman who was diagnosed with APL in the third trimester, and had no time to receive ATRA therapy before delivery. We managed this patient, although she suffered from massive post-partum hemorrhage due to severe hypo-fibrinogenaemia.A pregnant woman noticed purpuras on the trunk and upper extremities after the gestational age of 30 weeks. At the gestational age of 37 weeks, she had severe nasal bleeding continuing for an hour, and the blood test revealed pancytopenia. When she was referred to our hospital, DIC was accompanied with pancytopenia. Bone marrow aspiration was performed to obtain diagnosis, and the result showed 88% abnormal promyelocytes with fine heavy granules and fagotts. The findings were compatible with APL. Immediately after the admission, spontaneous labor began and she delivered 2978 g of a male infant. After the delivery of the placenta and the suture of the vaginal laceration, massive post-partum hemorrhage continued and the vaginal wall hematoma developed. Severe hypo-fibrinogenaemia persisted despite FFP replacement. Two hours after the delivery, the amounts of bleeding reached to 3,200 g. With the use of 2 g of fibrinogen concentrate, we conducted suture under general anesthesia, and finally the bleeding decreased. Then, the patient was treated by ATRA therapy and chemo-therapy. Three months later she had gained complete remission from APL.　This case shows that fibrinogen concentrate is useful to control huge postpartum hemorrhage in APL patients with hypo-fibrinogenaemia due to DIC