http://hdl.handle.net/10564/1564 2004-04 2026-04-10T15:40:43Z http://hdl.handle.net/10564/232 タイトル: 非切除進行胃癌症例に対する治療経験 著者: 成清, 道博; 山田, 行重; 上野, 正闘; 大東, 雄一郎; 三木, 克彦; 玉置, 英俊; 中島, 祥介 抄録: Inoperable advanced gastric cancer has a poor prognosis and yet has no standard therapy. Seven patients with inoperable advanced gastric cancer were treated with S-1, a novel oral anticancer drug based on the biochemical modulation of 5-FU (5-fluorouracil) or combination chemotherapy of 5-FU and CDDP (cisplatin) (low-dose FP therapy) in the hospital. All patients underwent outpatient treatment with oral administration of S-1. There were no noticeable adverse effects. The response rate was found to be 42% (3/7)(PR:3, NC:2, PD:2). The 50% survival time and 1-year survival rate were 448 days and 42%. To preserve the quality of life of cancer patients, it is worth considering outpatient treatment with S-1. 2004-04-29T15:00:00Z http://hdl.handle.net/10564/231 タイトル: 5-FU/CDDP療法中に多発脳梗塞を発症した進行胃癌の一例 著者: 成清, 道博; 山田, 行重; 中島, 祥介 抄録: A 64-year-old man visited our hospital with a chief complaint of appetite loss and epigastralgia. Upper GI series and an endoscopic examination revealed type 3 carcinoma on the upper third. Abdominal CT scan showed enlargement of the paraaortic lymph nodes that had invaded the pancreas. Preoperative diagnosis was cStage Ⅳ gastric cancer, and we considered a curative operation impossible. Therefore, chemotherapy with a combination therapy of 5-fluorouracil (5-FU) and low-dose cisplatin (CDDP) was planned. After 19 days of administration, the patient without vascular risk factors suddenly exhibited diplopia and left-member weakness. Brain CT showed a low- density area at the occipital lobe. Though we diagnosed cerebral infarction and treated with anti-thrombus therapy, he died of multiple cerebral infarction on day 12 of the treatrnent. 2004-04-29T15:00:00Z http://hdl.handle.net/10564/230 タイトル: 術中血管造影用カテーテルを用いた色素注入により至適切除範囲を決定し得た小腸angiodysplasiaの1例 著者: 向川, 智英; 高, 済峯; 成清, 博道; 田仲, 徹行; 中島, 祥介 抄録: We report a case of angiodysplasia of the small intestine in a 72-year-old woman frequently admitted to the Department of Gastroenterology in our hospital complaining of gastrointestinal bleeding of unknown origin since September 2000. She had massive gastrointestinal bleeding on April 22, 2002. Angiography revealed extravasation from a peripheral region of the fourth branch of the jejunal artery with early venous pattern which was diagnosed as angiodysplasia. The angiographic catheter was kept inserted for intraoperatively. She entered shock status and underwent emergency surgery. During the operation, we could not find the fourth point accurately by inspection and palpation, and so injected indocyaningreen via the angiographic catheter to identify the optimal surgical range. The stained part of the jejunum was resected inthelengthof50crn. The resected specimen revealed the pin-hole like bleeding point. Pathological examination showed characteristic features of a submucosal angiodysplasia in the 20cm 1ength of the jejunum. We conclude that intraoperative dye injection with the angiographic catheter is the reasonable method to identify the optimal surgical range in patients with small bowel hemorrhage. 2004-04-29T15:00:00Z http://hdl.handle.net/10564/229 タイトル: 腎孟腎炎による敗血症に対して,エンドトキシン吸着療法が有効であった2型糖尿病の1例 著者: 山路, 國弘; 川野, 貴弘; 山本, 純子; 的場, 和枝; 中川, 陽子; 京田, 有輔; 団野, 大介; 丸山, 直樹; 西浦, 公章 抄録: A case of type 2 diabetes mellitus treated successfully by endotoxin adsorption therapy for sepsis caused by pyelonephritis is reported. The patient was a 56-year-old woman, referring to our hospital for type 2 diabetes mellitus and essential hypertension. On January 31, 2001, she was admitted to our hospital because of left lateroabdorninal pain and frequent vomiting. Physical examination revealed blood pressure 130/80mmHg, heart rate 84/min, and body temperature 36.9℃. There was tenderness of the left flank and percussion pain of the left back. Blood examination revealed 8,000 white blood cells/μL, a CRP level of O.2mg/dL, and 108,000 platelets/μL. Urinary sediment revealed a white blood cell count of 30-49/HPF and bacteria positive. Abdominal CT on admission showed huge myoma uteri and dilation of the left renal pelvis. Therefore the case was diagnosed as hydronephrosis due to obstruction of the urinary tract and treated with antibiotics. But on the second hospital day, body temperature rose to 40℃ and Escherichia coli was detected by blood culture. On the 6th hospital day, blood examination revealed 38,000 white blood cells/μL, a CRP level of 13.9 mg/dL, and 16,000 platelets/μL, so the case was diagnosed as sepsis caused by acute pyelonephritis with disseminated intravascular coagulation (DIC) and treated by endotoxin adsorption therapy twice. Fever was diminishing after the 8th hospital day and on the 10th hospital day blood examination revealed 7,200 white blood cells/μL, a CRP level of 3.5mg/dL, and 112,000 platelets/μL. After that the clinical course was good, so she was discharged on the 40th hospital day. 2004-04-29T15:00:00Z