1997-02 http://hdl.handle.net/10564/1516 2026-04-09T11:20:17Z 2026-04-09T11:20:17Z 上林, 豊彦 中野, 公 桐田, 忠昭 中谷, 善幸 堀内, 克啓 杉村, 正仁 http://hdl.handle.net/10564/353 2017-05-29T06:07:02Z 1997-02-27T15:00:00Z

タイトル: 両側全頸部郭清術に際して内頸静脈再建を行った1例 著者: 上林, 豊彦; 中野, 公; 桐田, 忠昭; 中谷, 善幸; 堀内, 克啓; 杉村, 正仁 抄録: Neck dissection contributes not only to controlling the tumors but also to the probability of survival in the treatment of head and neck malignancies. Total neck dissection, which includes ligation and resection of the internal jugular vein, influences cerebral circulatory dynamics. Especially in the case of bilateral total neck dissection, maintenance of cerebral blood-flow is the most important consideration. The patient was a 54-year-old man with gingival carcinoma of the upper jaw. Following preoperative chemotherapy and radiotherapy, partial maxillectomy of the upper jaw and right total neck dissection were performed. Though the primary lesion and ipsolateral neck were controlled by the initial treatment, cervical metastasis surrounding the internal jugular vein of the contralateral side was recognized 2 years after surgery. Angiographs revealed collateral pathway of the right cervical region. However, the amount of blood flow was not sufficient. Left total neck dissection and reconstruction of the internal jugular vein with a femoral vein graft were performed, cohsidering an elevation of intracranial pressure. The grafted vein has remained patent, and there has been no evidence of cerebral complications. The patient has been followed up without recurrence or metas- tasis for 4 years.

1997-02-27T15:00:00Z 上林, 豊彦 中野, 公 岡本, 真澄 桐田, 忠昭 杉村, 正仁 美島, 健二 http://hdl.handle.net/10564/352 2017-05-29T06:07:02Z 1997-02-27T15:00:00Z

タイトル: 口蓋に発生した血管筋腫の1例 著者: 上林, 豊彦; 中野, 公; 岡本, 真澄; 桐田, 忠昭; 杉村, 正仁; 美島, 健二 抄録: We treated a case of angiomyoma of the palate in a 16-year-old female. She was referred to our hospital with the chief complaint of spontaneous pain of the palate. A crater-like ulcer with a relatively sharp margin, measuring 10×18 mm, was found on the left side of the palate. Partial bone resorption of the palate was found in occlusal radiograph and CT scanning. Histopathological diagnosis was angiomyoma. The tumor was surgically excised under general anesthesia with partial resection of the maxilla. There has been no evidence of recurrence or metastasis for 5 years 2 months after the operation.

1997-02-27T15:00:00Z 池田, 祐貴子 坂口, 奉弘 藤本, 眞一 籠島, 忠 土肥, 和紘 田中, 妥永子 橋本, 和子 高橋, 幸博 村田, 顕也 http://hdl.handle.net/10564/351 2017-05-29T06:07:02Z 1997-02-27T15:00:00Z

タイトル: 洞不全症候群の経過中に腎梗塞と脳梗塞を発症した先天性プロテインS欠損症の1例 著者: 池田, 祐貴子; 坂口, 奉弘; 藤本, 眞一; 籠島, 忠; 土肥, 和紘; 田中, 妥永子; 橋本, 和子; 高橋, 幸博; 村田, 顕也 抄録: We report a case of hereditary protein S deficiency with both renal and cerebral infarction during follow-up of a patient with sick sinus syndrome. A 50-year-old man required permanent pacemaker implantation at our department in May 1991 for sick sinus syndrome. Based on his abdominal pain, nausea, vomiting, increased LDH and enhanced renal CT findings, we diagnosed right renal infarction. On December 16, 1991, he was admitted to our department for left hemiparesis and speech disturbance. Because of recurrent thrombotic episodes, we measured protein C and protein S in this patient and his family members. The index patient, his elder brother, and his niece were found to have protein S deficiency. The most common manifestations of protein S deficiency are thrombo- phlebitis of the lower limbs and pulmonary embolism. This is a very rare case of hereditary protein S deficiency with recurrent arterial thrombosis, especially renal infarction.

1997-02-27T15:00:00Z 辻田, 重信 http://hdl.handle.net/10564/350 2017-05-29T06:07:02Z 1997-02-27T15:00:00Z

タイトル: 肝硬変における血中エンドトキシン不活性化機構に関する研究 : アルブミンの意義 著者: 辻田, 重信 抄録: Endotoxin binding and inactivating abilities of albumin were evaluated in patients with liver cirrhosis. Endotoxin binding capacity of albumin was significantly lower in Child C cirrhotics than that in Child A cirrhotics. There was a significant negative correlation between endotoxin binding capacity of albumin and Child-Pugh score. Plasma endotoxin inactivating rate in Child C cirrhotics was significantly lower than that in Child A cirrhotics, although plasma endotoxin inactivating rate in cirrhotics was generally greater than that in healthy subjects. Plasma endotoxin inactivating rate was positively related to endotoxin binding capacity of albumin. Endotoxin binding capacity of albumin was positively related to serum albumin and high density lipoprotein (HDL)-cholesterol. The addition of human albumin to cirrhotic plasma resulted in a significant increase in endotoxin binding capacity of HDL. Plasma interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α were negatively related to serum albumin. Plasma samples with high amounts of IL-1β, IL-6 and TNF-α showed marked decrease in endotoxin binding capacity of albumin. Albumin at concetrations of 1.5 or 3.0 g/dl was proved to inactivate 80 to 90 % of 250 pg/ml endotoxin in the chromogenic assay system. Albumin (10-1000 mg /dl) inhibited endotoxin uptake and TNF production by Kupffer cells in a rat experimental model. These results suggest that albumin is an important endotoxin binding protein which inactivates endotoxin and suppresses cytokine secretion from the Kupffer cells in liver cirrhosis. Thus, administration of albumin is considered to be beneficial to endotoxin inactivation in patients with advanced liver cirrhosis.

1997-02-27T15:00:00Z