薬理と治療

Volume 40, Issue 5, 2012
Volumes & issues:
-
扉・目次
-
-
-
ROUNDTABLE DISCUSSION
-
-
高齢者糖尿病の治療戦略- Diabetes & Cognitive Dysfunction -
40巻5号(2012);View Description
Hide Description
糖尿病において認知機能障害が進行するメカニズムは,血糖管理不良,血糖日内変動,低血糖,さらには,インスリン抵抗性とそれに伴う高インスリン血症など,さまざまである。今後,ますます増加することが危惧される高齢者糖尿病に対し,認知機能の維持,あるいは,低下した認知機能の改善を視野に入れた最善の糖尿病治療は何か,各専門医が集い,意見を交わした。 -
脳・心血管系イベントを抑制するために– これから始まる新しい糖尿病治療–
40巻5号(2012);View Description
Hide Description
糖尿病患者の心血管系イベント抑制が認められたPROactive と,認められなかったACCORD などとの違いをもとに,脳・心血管系イベントを抑制するための糖尿病治療,とくに最近登場したDPP-4 阻害薬の位置づけについて,専門医が意見を交わした。さらに,認知機能維持・改善を目指した高齢者糖尿病治療についても触れた。
-
-
TOPICS:第11回CRCと臨床試験のあり方を考える会議 2011 in岡山
-
- ●シンポジウム2 /製造販売後調査-現状と課題-
-
-
-
- ●シンポジウム7 /CRC とモニターの成功事例!-治験現場で協働するCRC とモニターによる工夫と協力が問題を解決する-
-
-
-
-
-
- ●シンポジウム10 /知っているようで知らなかった医療機器治験-医薬品治験との違いを中心に-
-
-
-
-
-
-
REVIEW
-
-
-
ORIGINAL ARTICLES
-
-
内視鏡用粘膜下注入材(0.4%ヒアルロン酸ナトリウム溶液,ムコアップ)の使用成績調査
40巻5号(2012);View Description
Hide Description
We conducted a postmarketing surveillance(PMS)study to investigate the safety and effectiveness of sodium hyaluronate solution(MucoUp)as a submucosal injectate during endoscopic mucosal resection(EMR)or endoscopic submucosal dissection(ESD)for gastric or colon tumor by using a central registration system. Out of 898 registered patients, 856 were included in the safety and effectiveness analyses. Adverse reactions were reported in 16 patients(1.9%)in total, which were comparable to that reported in the clinical trial(2.5%). Most of adverse reactions were haemorrhage in 11 patients(1.3%)and there were no reported shock and hypersensitivity, which were focused on the study as important events. Assessment of en bloc complete resection showed that the tumor was completely removed in 451(93.6%)of 482 patients with gastric tumor and 294(78.6%)of 374 patients with colon tumor. Assessment of the ease of mucosal resection revealed that the resection was rated easy or extremely easy in 389 patients(80.7%)with gastric tumor and 300 patients (80.2%)with colon tumor. The results were comparable to those of the clinical trial. Thus, the PMS study revealed no significant problem in the incidence rate or character of reported adverse reactions and showed a high en bloc complete resection rate and simplicity of mucosal resection. The study comfirmed that MucoUp was a useful infusion solution for EMR and ESD. -
Ameliorative Effects of Mosapride or Rikkunshi-to on the Suppression of Gastrointestinal Motility by Pirfenidone in Rats
40巻5号(2012);View Description
Hide Description
Objectives Pirfenidone(Pirespa), clinically used to treat idiopathic pulmonary fibrosis, often has the side effects of gastrointestinal disorders, including abdominal discomfort and anorexia. The purpose of this study was to assess the ameliorative effect of gastrointestinal prokinetic agents(mosapride or rikkunshi-to)on the pirfenidone-induced suppression of gastrointestinal motility in rats. Methods A test meal including 0.25%(w/v)Evans blue was orally administered at 1 hr after pirfenidone treatment with/without mosapride or rikkunshi-to. Animals were euthanized at 15 min after administration of the test meal, and the stomach and small intestine were isolated. Gastric emptying was measured using a spectrophotometer. Small intestinal transit was measured by calculating the distance the dye traveled to the total length of the small intestine. Results Pirfenidone at doses of 30 mg/kg or above induced a significant decrease in the gastric emptying rate, and 100 and 300 mg/kg of pirfenidone decreased the small intestinal transport rate. Concomitant dosing with mosapride at 3 and 10 mg/kg led to significant amelioration of the decrease in the gastric emptying rate induced by 100 mg/kg of pirfenidone. Mosapride at 1 mg/kg or above ameliorated the decreased small intestinal transport rate. Rikkunshi-to also showed ameliorating effects on the decrease in gastric emptying rate at 500 mg/kg and in the small intestinal transport rate at 100 mg/kg or above. Conclusion These results indicated that mosapride and rikkunshi-to are useful demulcents for treatment of gastrointestinal disorders induced by pirfenidone. -
-
自己フィブリン糊クリオシールの創傷治癒促進効果―市販フィブリン糊との効果比較―
40巻5号(2012);View Description
Hide Description
Objective Promotive effects of autologous fibrin glue(CryoSeal)produced by CryoSeal FS System(ThermoGenesis, USA)were compared with those of commercially available fibrin glues. Methods Fibrin glues were embedded at the base of incised wound of abdominal skin of rats. Adhesive strength of the glues was measured using a tensile strength tester at 30 min, 24 hrs and 7 days after embedding. Histopathological examination was undertaken on the skin samples collected at 7 days post embedding. Incised abdominal skins without fibrin glue embedding were served as control. Results Tensile strength gradually increased on time in all groups and they were consistently higher in the skins treated with fibrin glues in comparison with control. Among the fibrin glues, autologous fibrin glue showed a significantly higher adhesive effect comparing with other commercially available fibrin glues. Histopathologically, fibrin glues promoted wound healing by producing more amount of and matured granulation tissue under the regenerated epidermis covering the surface of wound. The autologous fibrin glue was absorbed and induced the proliferation of granulation tissue more promptly than commercially available fibrin glues. Conclusion Autologous fibrin glue promoted a rapid wound healing and contributed to higher tensile strength of incised wound of the skin in comparison with commercially available fibrin glues. The autologous fibrin glue was considered safe regarding the risks of contaminant infection/anaphylaxis and more effective tissue adhesive than commercially available fibrin glues. -
オルメサルタン メドキソミル(オルメテック)のアンジオテンシンⅡ拮抗作用―アンジオテンシン受容体拮抗薬間の比較―
40巻5号(2012);View Description
Hide Description
-