http://hdl.handle.net/10564/3495 2018-06 Fri, 10 Apr 2026 15:37:36 GMT 2026-04-10T15:37:36Z http://hdl.handle.net/10564/3515 タイトル: 右腸腰筋筋肉内脂肪腫が並存した後腹膜原発脱分化型脂肪肉腫の一例 著者: 谷, 里奈; 岸, 真五; 國安, 弘基 抄録: A 63-year-old woman was autopsied who showed a 20cm-sized tumor in the retroperitoneal cavity with progressive anemia. Histologically, undifferentiated tumor cells with eosinophilic cytoplasm were proliferating in a solid pattern. Some well-differentiated lipoma-like cells and lipoblasts were scattered. A necrotic area with hemorrhage was observed in the tumor; however, mitotic figures were found to be rare. In the adjacent skeletal muscle tissue, intramuscular lipoma was observed. In immunohistochemistry, the undifferentiated tumor cells were positive for CDK4 and p16. From these findings, the tumor was diagnosed as dedifferentiated liposarcoma. Fri, 29 Jun 2018 15:00:00 GMT http://hdl.handle.net/10564/3515 2018-06-29T15:00:00Z http://hdl.handle.net/10564/3514 タイトル: S-1/PTX療法が奏功した肝転移を伴う進行胃癌の一例 著者: 鶴井, 裕和; 大東, 雄一郎; 巽, 孝成; 森田, 敏裕; 蜂須賀, 崇 抄録: A 60-year-old-man was admitted to our hospital because of upper abdominal pain. Abdominal CT and endoscopic examination revealed type3 gastric cancer and liver metastasis 3cm in diameter, and advanced lymph node metastasis. We started chemotherapy using S-1 (120mg/body/day), orally administered for 2weeks followed by 1-week rest period, and paclitaxel (75mg/body) administered intravenously on day 1 and 8 as 1 course. After 16 courses of chemotherapy, the liver metastasis and the lymph node metastasis reduced markedly and could not be pointed out in abdominal CT. In upper gastrointestinal endoscopy, gastric cancer had changed to an ulcer scar. Tumor cells were not observed in only scar tissue in biopsy. 6 courses of chemotherapy were added at the patient's request. Six years have passed since the start of chemotherapy, but there are no signs of recurrence. Fri, 29 Jun 2018 15:00:00 GMT http://hdl.handle.net/10564/3514 2018-06-29T15:00:00Z http://hdl.handle.net/10564/3513 タイトル: 重症の閉塞性睡眠時無呼吸を伴わない肥満低換気症候群の1例 著者: 高橋, 輝一; 山内, 基雄; 藤田, 幸男; 吉川, 雅則; 片山, 公実子; 木村, 弘 抄録: A 50-year-old man with severe obesity was admitted to our hospital because of exertional dyspnea. Diagnostic polysomnography (PSG) revealed it to be Obesity Hypoventilation Syndrome (OHS), where the sleep disordered breathing was predominantly sleep hypoventilation rather than severe obstructive apnea-hypopnea. Non-invasive Positive Pressure Ventilation therapy was effective for this OHS patient. To understand the pathophysiology of OHS, we should consider the OHS phenotype that is sleep hypoventilation or severe obstructive sleep apnea (OSA) the predominant OHS, since treatment strategy differs for different phenotypes. Depending on the condition of right heart failure, rostral fiuid shift might occur during sleep, which will induce OSA. Therefore, to understand the exact OHS phenotype, we have to be careful about when diagnostic PSG should be performed. Fri, 29 Jun 2018 15:00:00 GMT http://hdl.handle.net/10564/3513 2018-06-29T15:00:00Z http://hdl.handle.net/10564/3512 タイトル: 医学生のための自己主導型学習　医学部入試と初年次教育を架橋するために 著者: 渡邊, 洋子; 藤本, 眞一; 柴原, 真知子; 大滝, 純司 抄録: In recent years, more and more enthusiasm and pressure have been put into the selection of the candidates for medical schools in ]apan, and a larger gap has been witnessed between the preparatory study and the pre-service training in medical education. As a result, there is a requirement for a shift in the learning attitudes of first-year students at an earlier stage. In this article, from the point of view of studies of education, and especially from that of the understanding of learners, we focus on a case study of an educational practice; the course of “Self-Directed Learning". The Self-Directed Learning (SDL) model was developed as a learning model suited to adult learners' characteristics, at the opposite end to the Teacher Directed Learning (TDL) model. In the class, new medical students learn about TDL and SDL based on the ideas of adult education (andragogy), reflect on their learning histories using the two models as frameworks, and participate in the exercise of utilizing human resources (with M. Knowles's textbook: Self-Directed Learning; A Guide for Learners and Teachers). Then, they identify the image of the medical doctors they wish to become, try to draw up a feasible route to their goal, and visualize their learning objectives, the learning process and procedures on their own Learning Contract sheets. Working on their own Learning Contracts, they also gain a prospect on their future learning process through the graduate years. In the results of the text mining analysis of their reflection papers, we could see the significance of providing the learners with opportunities to make Leaning Contracts at the beginning of the pre-service training. Further analysis of the data, and the development of a follow-up educational scheme are left to the next stage of our studies. Fri, 29 Jun 2018 15:00:00 GMT http://hdl.handle.net/10564/3512 2018-06-29T15:00:00Z