http://hdl.handle.net/10564/1505 2009-04 2026-04-10T15:44:12Z http://hdl.handle.net/10564/929 タイトル: 術前に良性腫瘍と診断した乳腺問質肉腫の1例 著者: 中村, 卓; 小林, 豊樹; 長井, 美奈子; 中島, 祥介; 伊藤, 高広; 吉川, 公彦; 森本, 由紀子; 吉田, 美鈴; 山下, 奈美子; 平井, 都始子; 武田, 麻衣子; 笠井, 孝彦; 野々村, 昭孝 抄録: A 56-year-old woman consulted a hospital because of a left breast mass. Mammography suggested breast cancer (Category 4). Ultrasonography demonstrated a 2cm mass lesion with clear-irregular border. Magnetic Resonance lmaging (MRI) demonstrated a mass with invasive lesion. Fine needle aspiration biopsy classified the mass as indeterrninate. But we diagnosed this lesion as benign phyllodes tumor or fibroadenoma. Open biopsy was performed. Pathological examination revealed stromal sarcoma of the breast with positive surgical stumps. Four weeks after the primary surgery, pectoral muscle preserving mastectomy with sampling of the axillary lymph node was couducted. The patient is alive and recurrence-free 12 months after surgery. 2009-04-29T15:00:00Z http://hdl.handle.net/10564/928 タイトル: PRIMARY SJÖGREN SYNDROME PATIENT PRESENTING CENTRAL NERVOUS SYSTEM MANIFESTATIONS SUCCESSFULLY TREATED WITH CORTICOSTEROIDS 著者: Okabayashi, Satoe; Fujimoto, Takashi; Danno, Daisuke; Kanno, Masatoshi; Nakamura, Shinobu; Kumazawa, Masahiro; Ueno, Satoshi 抄録: We treated a case of primary Sjören's syndrome with progressive central nervous systems manifestations. Central nervous system involvement in such patients is difficult to diagnose and rarely described. A 71-year-old man presenting with vertigo and vomiting was admitted to our hospital. Intension tremor developed in the left extremities and gradually spread to the right extremities, while an articulation disorder also appeared. Results of T2-weighted cranial magnetic resonance imaging on admission showed abnormally high intensity areas in the pons, medulla oblongata, and cerebellum, nearly all of which were on the left side. Laboratory findings showed a high level of serum γ-globulin, and were positive antinuclear antibodies, anti-Ro antibodies, and anti-La antibodies, while histological findings of a minor salivary gland biopsy revealed focal sialadenitis with marked lymphocytic infiltration. These serological and histopathological findings confirmed that the patient had primary Sjören's syndrome. The patient underwent pulsed intravenous methylprednisolone therapy, and blepharoptosis, miosis, kinetic tremors improved with the therapy. In addition, the intensities in T2-weighted cranial MR images in the pons and medulla oblongata disappeared, and cerebellar intensity improved. In view of the underlying autoimmune disorder, it seemed likely that the etiology of the CNS symptoms was related to inflammatory brain changes, such as from autoimmune-related vasculitis. 2009-04-29T15:00:00Z http://hdl.handle.net/10564/927 タイトル: 前駆期の治療不応性強迫症状が発症後に反応性となり改善した思春期統合失調症の1例 著者: 澤田, 将幸; 根來, 秀樹; 永嶌, 朋久; 岸本, 年史; 大西, 貴子; 飯田, 順三 抄録: Several psychiatric disorders have obsessive-compulsive symptoms. These symptoms have been noticed in schizophrenia since old times. Early-onset schizophrenia had obsessive-compulsive symptoms as premonitory symptoms only rarely. Arienti S. suggested that obsessive-compulsive symptoms prevented the onset of schizophrenia in patients with these symptoms. Matsumoto suggested that the patients had not good clinical courses because of these symptoms. In addition, it is said that the earlier onset age is, the slower progress is. Here we describe the case of an adolescent schizophrenia patient with long-tetm (about 5 years) refractory obsessive-compulsive symptoms, which improved after the onset of schizophrenia. The case might indicate the possibility that the onset of schizophrenia might be made to intprove these symptoms. 2009-04-29T15:00:00Z http://hdl.handle.net/10564/926 タイトル: IMMUNOCHEMOTHERAPY WITH INTERFERON-α, INTERLEUKIN-2, 5-FLUOROURACIL, AND CIMETIDINE FOR PATIENTS WITH ADVANCED RENAL CELL CARCINOMA 著者: Miyake, Makito; Fujimoto, Kiyohide; Tanaka, Masahiro; Hirao, Yoshihiko; Uemura, Hirotsugu; Otani, Takeshi; Yoshii, Masahito 抄録: Introduction. We prospectively evaluated the efficacy and safety of immunochemotherapy using INF-α, IL-2, 5-fluorouracil (5-FU), and cimetidine in patients with metastatic renal cell carcinoma (RCC). Patients and Methods. Twenty-two patients with metastatic RCC were given 4 weeks of initial therapy consisting of IFN-α (3-6x10^6 IU/day 3 times/week), IL-2 (0.7-1.4x10^6 JRU/day for 5 consecutive days/week), 5-FU (150 mg/m2/day for 5 consecutive days/week), and cimetidine (800 mg/day), followed by maintenance therapy with IFN-α, IL-2, and cimetidine. The response rate, overall and progression-free survivals, and adverse events were analyzed. Results. The median periods of therapy and follow-up were 4.4 months (range: 0.4 33) and 28.8 months (range: 1-65), respectively. The early anti-tumor effect was a complete response in one (4.5%), a partial response in 3 (13.6%), no change in 9 (40.9%), and progressive disease in 9 (40.9%). The 2-year progression-free and overall survival rates were 31% and 76%, respectively. The overall survival of cytokine-naive group was higher than that of cytokine-resistant group (p＜0.032). Adverse events of grade ≦3 occurred in 5 patients, and 9 discontinued this therapy due to adverse events. Conclusion. The present regimen had a low response rate despite the high incidence of adverse events and should be limited to patients with cytokine-naive metastatic RCC. 2009-04-29T15:00:00Z