http://hdl.handle.net/10564/1725 2011-04 Thu, 09 Apr 2026 01:04:17 GMT 2026-04-09T01:04:17Z http://hdl.handle.net/10564/1731 タイトル: 腹膜刺激症状により発症した魚骨による回腸穿孔の一例 著者: 辻, 裕樹; 岡村, 和哉; 相原, 洋祐; 吉治, 仁志; 山尾, 純一; 池中, 康英; 野口, 隆一; 森岡, 千恵; 中西, 啓祐; 白井, 勇作; 福井, 博; 石岡, 興平; 中村, 信治; 中島, 祥介 抄録: We report herein a rare case of ileum perforation by fish bone associated with severe manifestations of peritonitis. A 54-year-old man with chronic hepatitis C (CHC) and nephrotic syndrome was admitted into our hospital to receive interferon therapy. A couple of days after admission, he suddenly complained of a severe abdominal pain with diffuse tenderness. Enhanced computed tomography revealed an ileum perforation by a sharp thin object. Since he had severe clinical manifestations of peritonitis, an emergency operation was performed. This surgery revealed an ileum perforation by needle-like material and opaque ascites. Histological examination showed acute mucosal inflammation of the ileum with a fish bone. In most cases, the perforation hole is small, and the main clinical manifestation is usually localized limited abdominal pain but not diffuse tenderness. In these cases, conservative therapies such as endoscopic approach can be selected but not an emergency operation. However, when there is ascites, severe peritonitis can immediately result from leak of several toxic substances such as the ileum juice, endotoxin, and microbacteria into the peritoneal cavity. We have to take into account that even a small perforation by a fish bone may rapidly cause diffuse peritonitis under the condition of ascites such as nephrotic syndrome. Fri, 29 Apr 2011 15:00:00 GMT http://hdl.handle.net/10564/1731 2011-04-29T15:00:00Z http://hdl.handle.net/10564/1730 タイトル: 主膵管に近接した膵頭部インスリノーマを核出しえた1例 著者: 植田, 剛; 瀧, 順一郎; 越智, 祥隆; 吉田, 英晃 抄録: A 76 year-old man had presented consciousness disturbance since about 2000 ; it was diagnosed as transient cerebral ischemic attack or an epilepsy stroke. He was found to have hypoglycemia at the end of 2004 and was admitted to our hospital for a careful examination. Abdominal enhanced CT showed a hypervascular round mass about 15 mm in diameter located in the pancreatic head. An arterial stimulation venous sampling suggested that the tumor was fed by the inferior pancreaticoduodenal artery and the gastroduodenal artery. The tumor was interpreted as consistent with islet cell tumor, so-called insulinoma, in the pancreatic head. He underwent surgical resection at the end of April, 2005. By intraoperative ultrasonography, the tumor was shown to be in the pancreatic head, located near the main pancreatic duct and common bile duct. We used a Cavitron Ultrasonic Surgical Aspirator and could enucleate while confirming the relation of the tumor and the main pancreatic duct in real time by intraoperative ultrasonography. Fri, 29 Apr 2011 15:00:00 GMT http://hdl.handle.net/10564/1730 2011-04-29T15:00:00Z http://hdl.handle.net/10564/1729 タイトル: PSYCHOTHERAPEUTIC NURSING FOR A PATIENT WITH AMYOTROPHIC LATERAL SCLEROSIS 著者: Jikumaru, Kiyoko 抄録: The Psychotherapeutic Nursing (PTN) is a holistic care to ease physical pain and emotional-social agony, and to support psychological development and growth of patients with physical illness or injury. This approach is expected to help them become aware of, and satisfy, their suppressed needs and desires. In this research, the author, a nurse and psychotherapist, applied the PTN to a patient in a terminal stage of amyotrophic lateral sclerosis (ALS), and investigated the psychological process of the patient under the PTN. The patient, once overwhelmed by anticipatory anxiety and fear of death, overcame conflicts and fear of death, came to adapt himself to his miserable fate, accepted death, and finally passed away in peace with the intervention of PTN. In this process, the author supported him in expressing and then satisfying his definite and specific needs and desires with arrangement of human and physical resources. Information and ideas were exchanged among the staff so that the same goal could be shared, and the entire ward functioned psychotherapeutically. The patient died a peaceful death, being respected as a human being. Fri, 29 Apr 2011 15:00:00 GMT http://hdl.handle.net/10564/1729 2011-04-29T15:00:00Z http://hdl.handle.net/10564/1728 タイトル: 臍帯血移植の奇跡的経験 著者: 森井, 武志; 天野, 逸人; 田中, 晴之 抄録: 臍帯血移植はその利便性から近年急速に施行件数が増加しているが，施設間で治療成績の差が大きく評価が定まらないため現状では臨床試験としておこなうべき治療法とされている.当科では奇跡的ともいえる劇的な治療効果を多数経験しているので代表的な5例を提示し臍帯血移植の有用性を紹介する. [症例1]72歳男性，骨髄異形成症候群白血化，移植後4年間寛解維持. [症例2]49歳男性，NK細胞リンパ腫・鼻型，治療抵抗性，中枢神経浸潤，移植後79か月間無病生存中. [症例3]22歳男性，神経芽細胞腫，全身骨転移あり，移植後20か月生存. [症例4]66歳男性，急性型ATL，中枢神経浸潤，非寛解で移植，移植後34か月間無病生存中. [症例5]22歳女性，EBV陽性T細胞リンパ増殖異常症，皮膚潰瘍形成あり，移植後32か月間無病生存中. 内容記述: 個人の特定が出来ると思われる写真が掲載されているため本文PDFの登録はなし Fri, 29 Apr 2011 15:00:00 GMT http://hdl.handle.net/10564/1728 2011-04-29T15:00:00Z