真鍋 徳子

BACKGROUND: The effects of black tea consumption on cardiovascular risk factors have been inconsistent in previous randomized trials, all of which have been limited to a few weeks duration. METHODS: We conducted a pilot parallel-design randomized controlled trial among 31 adults aged 55 years and older with either diabetes or 2 other cardiovascular risk factors but no established clinical cardiovascular disease. Participants were randomized to drink 3 glasses daily of either a standardized black tea preparation or water for 6 months. Cardiovascular risk factors were measured at the beginning and conclusion of the study. RESULTS: Three participants dropped out of the study, leaving 14 participants assigned to tea and 14 assigned to water eligible for analyses. We found no statistically significant effects of black tea on cardiovascular biomarkers, including lipids, inflammatory markers, hemoglobin, adhesion molecules, prothrombotic and fibrinolytic parameters, and lipoprotein oxidizability. Assignment to tea did not appreciably influence blood pressure, and heart rate among participants assigned to tea was marginally higher than among control participants at 3 months (P = .07) but not 6 months. CONCLUSIONS: In this randomized trial of black tea intake over 6 months among older adults with known cardiovascular risk factors, black tea did not appreciably influence any traditional or novel biomarkers of cardiovascular risk. Longer randomized trials are needed to verify the inverse association of tea with risk of cardiovascular disease seen in cohort studies and identify potential candidate mechanisms for such an association.

A 69-year-old woman had severe aortic stenosis with a circumferentially calcified aorta from the ascending aorta to the aortic arch, and moderately impaired left ventricular function. Implantation of an apicoaortic valved conduit was performed as aortic clamping was not feasible. The early results were excellent.

We describe radiologic findings of germinoma involving bilateral basal ganglia and cerebral white matter. In the early stage, T1-weighted MR images showed hyperintense areas in the bilateral globi pallidi. Later, T2-weighted images showed hyperintense areas involving bilateral white matter. The MR imaging findings reported here could help facilitate the early diagnosis of germ cell tumors in young patients.

BACKGROUND: The aim of the present study was to describe the effectiveness and feasibility of high-resolution computed tomography (HRCT) in patients in supine and prone positions to detect amiodarone-induced pulmonary toxicity (APT). With regard to the possible differential diagnosis, our second goal was to emphasize the clinical value of HRCT with the patients in supine and prone positions compared with other paraclinical tests. METHODS AND RESULTS: Thoracic HRCT taken in both positions for 23 patients who were administrated amiodarone were prospectively evaluated in the current study. High-resolution computed tomography scans obtained with the patient in a prone position were helpful in differentiating dependent opacity from lung disease in 11 out of 23 patients. In another 4 patients, HRCT scans obtained with the patient in a prone position were useful in confirming the presence of subtle ground-glass opacities, considered as APT. Combination of HRCT in supine and prone positions provided a more reproducible method for evaluating the global extent of APT than other paraclinical tests. CONCLUSIONS: High-resolution computed tomography used in prone positions as well as a supine position could be an effective technique for reducing false-positive results in detection of APT and preventing the clinically serious pulmonary adverse effects by amiodanone.

The purpose of this article is to review the characteristics of computed tomography (CT) and magnetic resonance imaging (MRI) of the pericardium and pericardial diseases. Because patients with pericardial diseases usually present with nonspecific symptoms, these diseases may not be detected until they have reached an advanced stage. It is therefore important to distinguish between normal pericardial structure and disease. Multiplanar reconstruction images of CT and MRI are useful for evaluating faint changes of the pericardium. The specific pericardial diseases described in this article include pericardial cyst, constrictive pericarditis, pericarditis with radiation pericarditis, postoperative pericardial hematoma, and cardiac tamponade due to a paracardiac mass (lymphoma).

A 22-year-old Japanese man with Brugada syndrome was resuscitated from cardiopulmonary arrest. In addition to the electrocardiographic evidence of the syndrome and the absence of apparent structural heart disease, no accumulation of iodine-123-metaiodobenzylguanidine (MIBG) was found anywhere throughout the heart. Thallium-201 (Tl) single photon emission computed tomography (SPECT) distribution showed no significant decrease in its uptake. To our knowledge, this is the first report that has demonstrated a homogeneous absence of cardiac accumulation of MIBG in Brugada syndrome.

68歳男.咳嗽と夕方の発熱が持続した.白血球増多を指摘され,入院した.腹部CT検査で胆嚢癌が認められた.胆嚢癌は手術適応なしと判断し,発熱に対し抗生剤,NSAIDsを投与して対症的に経過観察した.経過中,naproxen,ampiroxicamが原因と考えられる薬疹が出現したため,これらの薬剤は中止し,diclofenac sodiumに変更した.全身状態の改善が認められたため,一時退院となったが,体重減少・全身倦怠感・浮腫など全身状態の悪化が見られたため,再入院となった.腫瘍サイズは2倍以上に増大し,肝転移像も認めた.徐々に全身状態は悪化し,死亡した.組織学的所見では,多形核を有する異型細胞の増殖が見られ,低分化腺癌と診断した.又,腫瘍細胞は抗G-CSF抗体を用いた免疫染色で陽性で,G-CSF産生腫瘍と考えた

心肺停止後蘇生され,心肺停止の原因が心原性と考えられ,かつ急性冠症候群と診断した11例を,急性心筋梗塞群(5例)と冠攣縮性狭心症群(6例)に分類し,MIBG心筋シンチグラフィー所見を比較検討した.MIBGは15分後(初期)像において左心部(H)と上縦隔(M)に関心領域を設定し,H/M比をMIBG取り込みの指標とした.冠攣縮性狭心症群の平均H/M比は2.217±0.306,急性心筋梗塞群の平均H/M比は1.590±0.299で冠攣縮性狭心症群で有意に取り込みが多かった

Purpose: Our intent was to investigate the role of radiotherapy in treating external auditory canal squamous cell carcinoma, especially in early stages of disease. Materials and methods: The treatment results for 20 patients treated between 1980 and 1998 were retrospectively analyzed. Radiotherapy was used as an initial treatment without surgery in eight patients and with surgery in 12 patients. The patients treated by radiotherapy alone received 65 Gy in 26 fractions over 6.5 weeks. The patients treated with radiotherapy perioperatively received 30-75 Gy in 12-30 fractions. The follow-up period for survivors including patients died of intercurrent disease ranged from 7 to 205 months (mean: 71 months). Results: The 5-year survival rate calculated by the Kaplan-Meier method for all patients was 59%. According to Stell classification (Laryncol. Otol. 99 (1985) 847), the 5-year survival rates for eight patients with T1 disease and eight with T2 disease were 100 and 38%, respectively. In the eight patients with T1 disease, disease control was 100%. Local control with hearing preservation was achieved in five patients with T1 disease by radiotherapy alone. No late complications related to radiotherapy were observed. Conclusions: A precise diagnosis of the disease in terms of whether or not it has invaded the bone is important in order to predict the treatment outcome. Radiotherapy with or without surgery is the treatment of choice for patients with T1-stage disease. Surgery with radiotherapy is recommended as standard care for tumors with bony invasion. Copyright (C) 2000 Elsevier Science Ireland Ltd.