日本小児外科学会雑誌
Online ISSN : 2187-4247
Print ISSN : 0288-609X
ISSN-L : 0288-609X
19 巻, 1 号
選択された号の論文の138件中1~50を表示しています
  • 原稿種別: 表紙
    1983 年 19 巻 1 号 p. Cover1-
    発行日: 1983/02/20
    公開日: 2017/01/01
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  • 原稿種別: 表紙
    1983 年 19 巻 1 号 p. Cover2-
    発行日: 1983/02/20
    公開日: 2017/01/01
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  • 原稿種別: 付録等
    1983 年 19 巻 1 号 p. App1-
    発行日: 1983/02/20
    公開日: 2017/01/01
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  • 原稿種別: 付録等
    1983 年 19 巻 1 号 p. App2-
    発行日: 1983/02/20
    公開日: 2017/01/01
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  • 原稿種別: 付録等
    1983 年 19 巻 1 号 p. App3-
    発行日: 1983/02/20
    公開日: 2017/01/01
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  • 原稿種別: 付録等
    1983 年 19 巻 1 号 p. App4-
    発行日: 1983/02/20
    公開日: 2017/01/01
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  • 原稿種別: 付録等
    1983 年 19 巻 1 号 p. App5-
    発行日: 1983/02/20
    公開日: 2017/01/01
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  • 原稿種別: 付録等
    1983 年 19 巻 1 号 p. App6-
    発行日: 1983/02/20
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  • 原稿種別: 目次
    1983 年 19 巻 1 号 p. Toc1-
    発行日: 1983/02/20
    公開日: 2017/01/01
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  • 伝 俊秋, 岩井 直躬, 柳原 潤, 間島 進, 井端 泰彦
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 13-20
    発行日: 1983/02/20
    公開日: 2017/01/01
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    It has been known that histological distribution of VIP and substances P in the colon in Hirschsprung's disease is influenced in some degree by immunohistochemical procedure. However the detail has not been cleared yet. In this study, we have investigated the alteration of VIP and substance P distribution in the colon of Hirschsprung's disease by PAP immunohistochemistry of Sternberger. The colonic tissue of the narrow segment, including the adjacent proximal dilated colon, was obtained from two patients of Hirschsprung's disease. The tissue was incized into 5 mm in length, fixed in Bouin's solution and embedded in paraffin. Serial sections of 6 μm in thickness were made and stained by the usual unlabeled antibody enzyme method. VIP immunoreactive nerve cell bodies, nerve fibers and nerve terminals were found to distribute in the ganglionic and oligoganglionic segments. On the contrary, in the aganglionic segment, neither VIP immunoreactive nerve fibers nor nerve terminals could be detected in the both plexuses, and fibers of propria mucosa were slightly distributed. Substance P immunoreactive nerve cell bodies nerve fibers and nerve terminals also distributed in the ganglionic segment. However, no substance P immunoreactivity was found in the oligo- and aganglionic segments. It is recognized that VIP produces relaxation of the smooth muscle of the bowel and substance P stimulates the intestinal movement. It was proved in the present study that VIP and substance P immunoreactivities decrease or deplete in the colon of Hirschsprung's disease. It has been suggested, therefore, that the lack of VIP and substance P is possibly the cause of obstructive symptom in Hirschsprung's disease.
  • 大川 治夫, 澤口 重徳, 山崎 洋次, 石川 詔雄
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 21-26
    発行日: 1983/02/20
    公開日: 2017/01/01
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    In cases of cylindrical choledochal dilatation in association with anomalous panereatico-biliary ductal union, the clinical episodes of righ upper quadrant pain, vomiting and fever are recurrently observed. Hyper-amylasemia is seen at each of these episodes, which is generally considered to be caused by acute pancreatitis. However, according to our observations in clinical and experimental studies to date, hyper-amylasemia is supposed to be related to existence of amylase in the biliary system. The purpose of this paper is to prove this relationship through a series of experiments. Twenty-two mongrel dogs underwent laparotomy under intravenous pentobarbital anesthesia. A 14G double lumen tube was inserted into the choledochus. Cystic duct was ligated. The choledochus was inflated with continuous hydrostatic pressure of 20cm H2O for 2 hours. Four groups were designed according to the various concentration of amlase and lipase in the infused fluid. The first contrast group of 5 dogs were infused with 200 ml of lactated Ringer's solution. The second porcine pancreas group of 6 dogs were infused with 40,000 U of amylase from porcine pancreas and 2,000 U of lipase from Rhizopus arrhizus, which were diluted in 200 ra.1 of lactated Ringer's sulution. The third bacillus amylase group of 6 dogs were infused with 120,000 U of amylase from bacillus subtilis and 2,OOO U of lipase from Rhizopus arrhizus, which were diluted in 200ml of lactated Ringers solution. The fourth group of 5 dogs were infused with 20ml of bile juice, containing pancreatic juice, from canine models of anomalous pancreatico-biliary ductal union, which were diluted in 180ml of lactated Ringer's solution. In groups III and IV, hyper-amylasemia were proven in 60 to 120 minutes after the start of infusion with a statistical significance. Moreover, amylase isozyme patterns of porcine pancreas and bacillus subtilis were distinctly different from dog's amylase isozyme pattern. The gradual increase of these foreign isozymes were demonstrated singnificanlty in accordance with infusion. In this way, this experiment proved a possible presence of the direct passage of amylase and lipase through the hepato-choledochal system. This phenomenon has long been exylained as a cholangio-venous reflux.
  • 荒木 周平, 池田 光則, 北條 禎久, 坂尾 寿彦, 木村 茂
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 27-31
    発行日: 1983/02/20
    公開日: 2017/01/01
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    In neonatal jaundice, differentiation of biliary atresia from neonatal hepatitis is difficult. Several methods of differential diagnosis have been devised such as CBA score test and others. CBA score test has been made from history, physical findings and dada of chemical examinations. However, methods of chemical examination are different for each facility. Therefore, the data of chemical examination are needed to be revised in each facilities. This paper describes a trial to revise the CBA score test using discriminative analysis. Twentyeight cases of neonatal jaundice have been subjected to the study. As chemical examination for this discriminative analysis, direct bilirubin, GOT, GPT and alkaline phosphatase were used. The case with over 5 points on CBA score test has been decided to be biliary atresia. In our 14 cases which need not operation, 4 of 5 cases with over 5 points on original CBA score test have become under 5 points using this discriminative analysis. It seems that the misdiagnosis of neonatal hepatitis for biliary atresia decreased by using this analysis. This discriminative analysis is one of the evolution for CBA score test. It is important to make more useful score count with modifing CBA score in each facilities.
  • 田辺 政裕, 高橋 英世, 大沼 直躬, 江東 孝夫, 岩川 真由美, 宮本 忠昭, 大津 裕司, 南久松 真子
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 33-40
    発行日: 1983/02/20
    公開日: 2017/01/01
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    Seven childhood tumor xenografts in nude mice (BALB/C, nu/nu) were studied with regard to their morphology, karyotype, growth kinetics, and ability to produce human proteins. Seven of 19 childhood tumors could be serially transplanted in nude mice, i. e. neuroblastoma (CH-NB-1), Wilms' Tumor (CH-W-1, 2, 3), hepatoblastoma (CH-HB-1), rhabdomyosarcoma (CH-RS-1), yolk sac tumor (CH-YS-1). These xenografts preserved the original histology and also mainteined human chromosomal patterns. Two lines of hepatoblastoma (CH-HB-1) and Wilms' Tumor (CH-W-3), have histologically changed during serial transfers. A well differentiated type of hepatoblastoma has changed to a poorly differentiated type and complex subtype of Wilms' tumor to epithelial type. The growth rates in the exponential growth phase differed from 4. 5 to 20 days in volume doubling time, although the growth patterns of all xenografts followed a Gomperts curve. Hepatoblastoma (CH-HB-1) and yolk sac tumor (CH-YS-1) produced both α-fetoprotein and normal serum proteins. The serum values of α-fetoprotein increased progressively in relation to growth of the tumor. These results suggest that childhood tumor xenografts in nude mice preserve morphologic and functional properties of original tumors and are available for studies in experimental therapeutics.
  • 鈴木 信子, 松村 長生
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 41-46
    発行日: 1983/02/20
    公開日: 2017/01/01
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    Detection of the bilirubin conjugate "C", the major bilirubin conjugate, in the serum by means of HPLC is significant to differentiate CBA (congenital bile duct atresia) from other neonatal jaundice. The present studies have been performed to ascertain availability of this method on serum specimens of newborn babies with jaundice and of rats with experimental model of cholestasis. CBA babies within two months of age have a plasma bilirubin conjugate pattern of diglucuronide/conjugate "C" ratio (DG/"C") below one, while these beyond two months of age showed DG/"C" above one. The DG/"C" ratio was also above one in the serum of babies with congenital intrahepatic cholestasis. The DG/"C" ratio was below one in rats with complete bile duct obstruction, while the ratio was above one in rats with incomplete bile duct obstruction, ANIT-induced cholestasis, and d-galactosamine-induced liver injury. These results in newborn babies and rats with experimental model of cholestasis seemed to coincide with each other, and the characteristic finding is that the DG/"C" ratio below one is observed only in CBA babies below two months of age and rats with complete bile duct obstruction within 48 hours after operation. It was concluded, therefore, that determination of DG/"C" ratio in serum by means of HPLC is useful to differentiate CBA babies within two months of age from others with neonatal jaundice of various etiologies.
  • 宮野 武, 駿河 敬次郎, 新井 健男, 出口 英一, 下村 洋, 鈴木 不二彦, 江口 正信, 松本 道男
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 47-52
    発行日: 1983/02/20
    公開日: 2017/01/01
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    Specimens of excised rudimentary biliary tract which were obtained from the porta hepatis at the time of surgery was investigated histologically from the viewpoint of number and size of ductulus utilizing Image Processing System (MUTOH) in thirty five patients with uncorrectable biliary atresia. Cases were divided into two groups depending on their postoperative course, particulary the amount of postoperative bile flow. Group A (13 cases) : no jaundice, good bile flow (more than 100 ml/day at the time of postoperative 6 months). Group B (22 cases): jaundiced, poor bile flow (less than 100 ml/day at the time of postoperative 6 months). There was no significant difference of the number or the size of ductulus at the porta hepatis between these two groups.
  • 大井 龍司, 花松 正寛, 望月 泉, 葛西 森夫
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 53-61
    発行日: 1983/02/20
    公開日: 2017/01/01
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    Operative cholangiograms of 34 patients with infantile obstructive jaundice were analysed concerning the size of the common bile duct, simultaneous visualization of the pancreatic duct and bilio-pancreatic common channel, and the length of the common channels. The 34 patients consisted of 19 subtype "a" biliary atresia, 7 neonatal hepatitis and 8 hepatic ductular hypoplasia. The size of the common bile ducts in subtype "a" biliary atresia ranged from about 0. 5 mm to 1.2 mm in diameter. From an analysis of operative results after hepatic portocholecystostomy, this procedure should be abandoned when a size of the common bile duct was less than 1. 0 mm in patients of subtype "a" biliary atresia. The pancreatic ducts were visualized simultaneously in 17 of 18 subtype "a" biliary atresia, in 6 of 7 neonatal hepatitis, and in all of 6 hepatic ductular hypoplasia patients. The bilio-pancreatic common channel were also present on the cholangiograms in 14 of 16 subtype "a." biliary atresia, in 3 of 7 neonatal hepatitis and in all of 6 hepatic ductular hypoplasia patients. The presence of common channel in patients with these diseases appeared not to be pathologic but to be physiologic condition in this age.
  • 長屋 昌宏, 伊藤 喬広, 山田 昂, 渡辺 芳夫
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 63-70
    発行日: 1983/02/20
    公開日: 2017/01/01
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    We produced a new 5-lumen manometric catheter with an outer diameter of 6mm. The catheter has four radial recording lumens which have each a side-hole orifice at the same level, 2 mm above the distal end, and one central recording lumen which has a end-hole orifice. The tone and the length of high pressure zone in 14 dogs were measured by use of this catheter with constant perfusion of water at a rate of 30 ml/hr. The results were as follows: 1. Radial asymmetry of high pressure zone was significant in dogs, thus the left-posterior pressure was the biggest and the right-anterior pressure was minimum. 2. The tone obtained from the end-hole catheter (Y) was well correlated to about 70% of the mean value from four side-hole catheters (X). Y=0.67X+7.9 3. The lenghth of high pressure zone from the end-hole (Y) was also correlated to the mean length of four side-holes (X). Y=0.39X+4.3 We speculated upon the mechanism in tracing of high pressure zone, and obtained the following conclusion. The value obtained with the end-hole catheter would correspond to the true opening pressure of gastro-esophageal junction, whereas the value obtained with the side-hole catheter might be higher than the resting tone, because the wall of gastro-esophageal junction can be stretched by the catheter during the tracing, and it would produce the increase in the wall tension.
  • 木戸脇 卓郎, 坂本 泉, 川勝 秀一, 竹内 義博, 石井 孝司, 田中 輝房, 沢田 淳, 楠.智一 , 雨貝 孝
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 71-76
    発行日: 1983/02/20
    公開日: 2017/01/01
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    Possible detection of metastatic neuroblastoma (NB) cells in bone marrow was investigated by indirect immunofluorescence using A2B5 monoclonal antibody (MA). This MA is reported to define the GQ ganglioside determinant on the neural cells by Eisenbarth et al. Primary tumor cells from one paint with NB (stage III), bone marrow aspirates form 7 patients with NB (stage II: 1, stage III: 1, stage IV: 2, and stage IVs : 3 cases respectively) and from one patient with acute monocytic leukemia, and murine NB cells were used in this study. The presence of NB cells in these specimens were simultaneously examined by conventional methods such as MayGiema and/or catecholamine fluorescent stainings. The detectability of NB cells by A2B5 MA were well correlated with that of conventional methods in one primary tumor specimen and bone marrow specimens with or without NB involvement. However, in one bone marrow specimen with negative detection of NB cells by catecholamine fluorescent staining, the presence of NB cells were demonstrated by A2B5. Murine NB cells reacted with A2B5, whereas acute monocytic leukemia cells did not. These results indicated that the membrane phenotypic study using A2B5 MA could be more potential method to detect the bone marrow metastatic cells especially in the catecholamine florescent negative NB cells.
  • 内山 昌則, 岩淵 真, 大沢 義弘, 山下 芳朗, 山際 岩雄, 内藤 真一, 曽我 淳, 武藤 輝-
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 77-82
    発行日: 1983/02/20
    公開日: 2017/01/01
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    Ovarian cyst and tumor in children are not such rare as have been generally concidered. Fifteen girls have been treated for ovarian cyst or tumor at our institute. Benign group underwent resection of tumor or cyst, and intermediate or malignant group underwent resection of the lesion with lymphnode dissection with or without chemotherapy and/or radiation. All patients including those with embryonal carcinoma, solid teratoma, lymphosarcoma and dysgerminoma, have shown no signs of recurrence with uneventful course. Two cases of dysgerminoma have beer completely free of disease for over 6 years after resection. One of these two patients underwent chemotherapy, and the other radiation-therapy after operation. Of 52 children with ovarian dysgerminoma which have been reported in 15 years in Japan, 31% were treated only by operation. However, other patients underwent operation and/or irradiation, and chemotherapy. Regarding to operation, 76 patients underwent lateral salpingoophorectomy. A total of 325 patients of ovarian cyst and tumor who were younger than 15 years of age have been reported in Japan during past 15 years. One hundred and eight patients (33%) were with cyst and 217 (67%) with solid tumor. One hundred and thirtythree cases (41%) were benign and 192 (59%) intermediate or malignant tumor.
  • 奥園 真一, 林田 裕, 水田 祥代, 中川 原章, 池田 恵一, 恒吉 正澄, 遠城寺宗知 , 松浦 啓一
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 83-88
    発行日: 1983/02/20
    公開日: 2017/01/01
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    A 2 year and 6 month old female is presented with yolk sac tumor originating from the vagina. The patient underwent hysterectomy, vaginectomy and dissection of the regional lymph nodes. Chemotherapy using actinomycin D, adriamycin, vincristine and cyclophosphamide (T-2 protocol) has been carried out with radiotherapy. Serum a-fetoprotein (AFP) level once decreased to reach the normal range after operation, but elevated again during the interval period of chemotherapy. However, AFP has decreased rapidly responding to resumption of the therapy. The patient has been free from recurrence to date for 2 years and 10 months after operation. Combination therapy with operation, chemotherapy and radiotherapy is needed in treatment of yolk sac tumor. Especially T-2 protocol is very effective.
  • 福井 雄一, 岡田 正, 池田 義和, 東島 哲也, 福澤 正洋, 川島 康生
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 89-95
    発行日: 1983/02/20
    公開日: 2017/01/01
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    An 18-month-old boy was admitted to the univeasity hospital because of a large abdomina mass since two month ago. Findings of upper GI series, computed tomography, ultrasonic echogram and aortography suggested a large cyst in the liver parenchym. A laparotomy revealed a mass arising from the right lobe of the liver. An extended right hepatic lobectomy was performed. The tumor was 23x19x11 cm and weighted 2,100 gm. The most part of the tumor was cystic containing clear yellowish fluid. By histological examination, the cystic wall was mainly formed of the collagenized fibrous tissue, and proliferation of the bile ducts and liver tissue were found. No malignant finding was observed. The diagnosis was "mesenchymal hamartoma". The patient had an uneventful postoperative course and shows no evidense of recurrence at 18 months after operation. Mesenchymal hemartoma of the liver is a rare benign tumor in infancy. This is the 21st reported case in Japan. Early operation followed by accurate diagnosis is advised.
  • 松岡 潔, 伊藤 保憲, 水田 稔, 浜脇 光範, 久保西 栄, 岡野 和雄, 楢原 幸二, 吉川 清志
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 97-107
    発行日: 1983/02/20
    公開日: 2017/01/01
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    The aniridia-Wilms' tumor syndrome has recently been found to closely related to an interstitial deletion of the short arm of chromosome 11. A mentally-retarded, one year and ten months old boy with the aniridia-Wilms' tumor syndrome was reported. He was recognized shortly after birth to have bilateral congenital aniridia and nystagmus. There was no family history of aniridia. After right nephrectomy for Wilms' tumor, he received Linac irradiation to the tumor bed, and Actinomycin D and Vincristin were given according to the NWTS protocol. One and a half years after operation, another tumor was detected in his left kidney, and he died 3 months later. Chromosomal analysis using trypsin-Giema banding was performed on prometaphase chromosomes from the peripheral lymphocytes culture, and the karyotype designation was determined to be 46, XY, del (11) (p11.1→p13). His mother and sister had normal karyotype. A patient with aniridia and del (11p13) is well known to have a high risk for the development of Wilms' tumor or gonadoblastoma. Seven cases of the aniridia-Wilms' tumor syndrome have been reported in the Japanese literature up to date, but the chromosomal deletion has not been described. In the world literature, 23 cases of aniridia with del (11p13) with or without Wilms' tumor have been reported: 13 with Wilms' tumor, 2 with gonadoblastoma, and 8 with no tumor. The etiology of aniridia-Wilms' tumor syndrome was discussed.
  • 末 浩司, 池田 恵一, 林田 裕
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 109-113
    発行日: 1983/02/20
    公開日: 2017/01/01
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    Leiomyoma is the most common benign tumor of the esophagus, but its familial occurence is very rare. Only a few cases has been reported in the world. Recently, we experienced the esophageal leiomyoma occured in sisters. The elder sister's tumor was recognized at 7 year old in 1966, which was probably the youngest case of the esophageal leiomyoma in Japan. The younger sister's tumor happened to be recognized at 18 in 1981. Both tumors are bigger, circular, and located in a lower third part of the esophagus. These characters are very like those of the other reported cases, and all cases are seen in females.
  • 宮下 勝, 山口 真弘, 橘 秀夫, 細川 裕平, 津川 力, 木村 健, 鄭 輝男, 三戸 寿
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 115-119
    発行日: 1983/02/20
    公開日: 2017/01/01
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    A twentyone-day-old boy with vascular ring was successfully treated. He had received a repair of tracheoesophageal fistula at the age of three days. Because of persistent respiratory distress postoperatively, bronchoscopy was carried out at the age of 11 days which revealed compression of the trachea and left main bronchus. Angiocardiography showed right aortic arch with aberrant left subclavian artery, persistent dorsal aortic arch and patent ductus arteriosus. The patient was operated upon at the age of 21 days. Left thoracotomy was done and the ductus arteriosus was devided. Then the trachea and esophagus were freed at the site of constriction and above and below it. Postoperative bronchoscopy showed the evidence of tracheomalacia. Aortopexy was performed for the treatment of tracheomalacia at the age of 2 and half months. His respiratory symptoms gradually improved thereafter. We believe that division of the left subclavian artery is not necessary in this type of vascular ring with large PDA, as the respiratory symptoms mainly due to compression of the trachea and bronchus by ductus, and excision of Kommerell's diverticulum is indicated only when the diverticulum is large. If tracheomalacia is present, aortopexy is recommended for the relief of tracheoesophageal compression in infant.
  • 山際 岩雄, 岩淵 真, 大沢 義弘, 渡辺 英伸, 内海 治郎, 浅見 恵子
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 121-132
    発行日: 1983/02/20
    公開日: 2017/01/01
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    A fourteen month old boy was admitted to Niigata University Hospital with the presence of abdominal mass and an associated hard mass on his left supraorbital region. Close examinations revealed neuroblastoma with metastases to bone and liver. The operative findings disclosed a tumor originating from the left adrenal gland, swelling of the paraaortic lymph nodes and multi-nodular metastases of both lobes of the liver. Reduction surgery was carried out consisting of resection of the primary tumor and lymph nodes dissection. At the time, a specimen for biopsy was taken from the metastatic lesion of the left lobe of the liver. Microscopic examination revealed a composite type of ganglioneuroblastoma of the left adrenal tumor and a rosett-fibrillary type of neuroblastoma of the metastatic sites. Thereafter, multimodal therapy consisting of chemotherapy, immunotherapy and maturational therapy was performed. The supraorbital mass disappeared and metastases of the liver were not visible on CT film. The second look operation was performed 2 years and 6 months after the initiation of treatment. The operative findings disclosed metastatic lesions of the liver altered to scars. Microscopic examination of the scars revealed fibrous tissue alone, or fibrous tissue with irregularly scattered ganglion cells or benign ganglioneuroma with fibrosis, and did not disclosed any evidence of the neuroblastoma tissue. There was no recurrence in the retroperitoneal region. The patient has been well for 3 years after initiation of the treatment.
  • 山中 清一郎, 中川 原章, 生野 猛, 後藤 誠一, 台丸 裕, 池田 恵一
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 133-138
    発行日: 1983/02/20
    公開日: 2017/01/01
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    A 1-year-3-month old girl presented with ganglioneuroblastoma originating in the neck. On examination, several elastic masses measuring from walnut-size to little-finger-tip-size were palpated in the right side of the neck. They were at first suspected to be cervical lymphadenitis, but showed no response to administration of antibiotics. The biopsy revealed that the neck tumor was histlogically ganglioneuroblastoma. The searches by body CT, intravenous pyelography, echogram and Ga scintigram demonstrated no sign of tumor in any other organ or tissue, which strongly suggested that the tumor was a cervical origin. All tumor masses were removed by modified neck dissection and the patient has received chemotherapy (James procedure) and irradiation. She is free from disease at 3 months after operation. This is the second case of cervical neuroblastoma among 41 cases of this disease expetienced in our department since 1960. In this paper, a literal review is included.
  • Yoshihide Ogawa, Shigeki Takahashi, Ryuichi Kitagawa, Tomokazu Umeyama ...
    原稿種別: Article
    1983 年 19 巻 1 号 p. 139-143
    発行日: 1983/02/20
    公開日: 2017/01/01
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    This is a case report of a metachronous bilateral Wilms' tumor. One year after the removal of the left kidney for a sarcomatous Wilms' tumor, the 5-year-old boy developed a metastatic lesion in the right kidney. Following radiation and chemotherapy autotransplantation was performed by means of bench surgery to remove the lesion completely. The patient experienced renal and adrenal insufficiency after the surgery and received radiation. He has been on chemotherapy and has been doing well one and a half years after the second operation.
  • 竹内 敏, 玉手 信治, 中平 公士, 門脇 宏, 永田 昇, 塩川 智司, 山田 忠治
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 145-150
    発行日: 1983/02/20
    公開日: 2017/01/01
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    In 18 patients with hypertrophic pyloric stenosis, endoscopic manometric and studies and pH monitoring were performed. Fourteen patients showed endoscopic evidence of esophagitis. In all 7 patients in whom hematemesis was seen, esophagitis was present. Results of the study strongly suggest that the major site of hemorrhage in this disease is the esophageal mucosa which was possibly damaged by reflux of gastric juice as the result of gastric outlet obstruction.
  • 森本 雅己, 志田 寛, 井之川 孝一, 津金 次郎, 杠 英樹
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 151-156
    発行日: 1983/02/20
    公開日: 2017/01/01
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    Forty-four patients ranging in age from 6 to 36 months underwent closure of a ventricular septal defect (VSD) under simple deep hypothermia without cardiopulmonary bypass. The VSD was closed by non-trans ventricular (transatrial and transpulmonary arterial) approach in 23 of these 44 patients. In the remaining 21 patients, it was closed by transventricular approach. The operative technique, incidence of postoperative complications and postoperative course were compared between these 2 groups. The following conclusions were obtained. 1) The operative technique of the non-transventricular closure of VSD was not difficult as well as the transventricular closure. 2) There was no significant difference in the incidence of the postoperative complete right bundle blanch block and other complications between the two approaches. 3) To the postoperative course, the non-transventricular closure of VSD had the advantage over the transventricular closure in early postoperative period.
  • 小沼 邦男, 古田 靖彦, 太田 淳
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 157-163
    発行日: 1983/02/20
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    We experienced 6 cases of testicular torsion during the last 17 years. The cases were 2 neonates, 1 infant and 3 children. Orchiopexy was performed, on 5 of 8 testes with satisfactory results. Three interesting cases were reported in details. Case 1. An 11-year-old boy visited our hostital complaining of left scrotal pain and swelling. The patient had been waiting for orchiopexy because of his left undescended testis. An emergecy scrotal exploration was done for left testicular torsion and orchiopexy was performed successfully. About 2 months later, right testicular torsion occurred. An emergency scrotal exploration was done and orchiopexy was performed successfully. Case 2. A 3-year-old boy visited our hospital because of his left scrotal swelling without pain. Transillumination test of left scrotum was positive. The diagnosis was left hydrocele testis at that time. Next day, the patient visited us again complaining of left scrotal pain. An emergency scrotal exploration was done, but left torsive testis could not be saved. Left hydrocele testis was thought to be the etiology of left testicular torsion. Case 3. An 11-month-old boy was diagnosed and treated as acute epididymo-orchitis by a pediatrician. Symptoms was not improved and patient was referred to us. An emergency scrotal exploration was done for left testicular torsion, but left torsive testis could not be saved. The diagnosis of testicular torsion is difficult. We suggest early surgical exploration for cases with suspicion of torsive testis, as most of them can be salvaged by reduction of torsion and orchidopexy.
  • 津川 力, 木村 健, 松本 陽一, 村田 洋, 山本 哲郎, 西島 栄治, 丸川 愛子
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 165-169
    発行日: 1983/02/20
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    Three patients aged from 6 days to 2 years have been successfully treated for glottic or subglottic stenosis of either congenital or acquired origin by endoscopic electrosurgical resection. A Storz infant urethral resectoscope was used for resection of the stenotic lesion. In a 6 day old newborn, the congenital supraglottic web was successfully resected. The patient had been adequately ventilated via a fine catheter passed over the web, and then resection of the web was safely carried out immediately after removal of the ventilating catheter. By this technique, creation of tracheostomy could be avoided. The other tow patients presented with acquired subglottic stenosis due to prolonged endotracheal intubation. In these patients, there had been tracheostomy through which ventilation was maintained during the procedure. For endotracheal circumferential scar, the posterior portion was not excised to avoid the esophageal damage. After the procedure, the patients were managed with an endotracheal stent tube for 2 to 68 days and finally extubated. During the followup period period from 7 to 11 months, there has been no evidence of recurrent airway obstruction in these patients. It has been suggested that endotracheal resection of the stenotic lesion is possible even in a newborn by use of an infant resectoscope.
  • 浅井 康文, 兼古 悟, 杉本 健司, 大堀 克己, 安倍 十三夫, 小松作蔵
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 170-
    発行日: 1983/02/20
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  • 松倉 裕美, 川上 敏晃, 太田 里美, 横田 晃, 安田 慶秀, 松波 己, 菅原 啓, 水戸 康文, 児嶋 哲文, 立木 利一, 田辺 ...
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 170-
    発行日: 1983/02/20
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  • 稲尾 雅代, 渡辺 祝安, 樫野 隆二, 国谷 良紀, 吉村 英敦, 梅津 征夫, 田宮 恵子
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 170-
    発行日: 1983/02/20
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  • 田村 正秀, 竹内 章二, 高木 勇, 竹内 克彦, 久保 良彦, 鮫島 夏樹, 岡 隆治, 吉岡 一, 百合野 方希
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 170-171
    発行日: 1983/02/20
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  • 塚本 勝, 稲岡 正己, 佐々木 孝, 安喰 弘, 小拙 作蔵, 太田 八千雄, 長谷 直樹, 浜田 勇
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 171-
    発行日: 1983/02/20
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  • 酒井 圭輔, 橘 秀光, 久保田 宏, 村上 忠司, 小西 貴幸, 屋敷 憲章, 佐竹 良夫, 川名 信, 百留 和雄, 真弓 享久, 岡隆 ...
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 171-
    発行日: 1983/02/20
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  • 表 哲夫, 鹿角 雅治, 田宮 恵子, 小林 尚司, 平間 敏憲, 樫野 隆二, 稲尾 雅代
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 171-
    発行日: 1983/02/20
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  • 斎木 功, 高橋 弘昌, 高木知敬 , 佐々木 文章, 秦 温信, 内野 純一
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 171-172
    発行日: 1983/02/20
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  • 原田 吉雄, 竹光 義治, 今井 充, 池崎 厚子
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 172-
    発行日: 1983/02/20
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  • 柴田 岳三, 真鍋 邦彦, 佐々木 文章, 秦 混信, 内野 純一, 藤田 仁子
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 172-
    発行日: 1983/02/20
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  • 工藤 正純, 後藤 洋一, 長谷川 正義, 高宮 雅, 亀田 博, 八木 禧徳, 赤坂 嘉宣, 服部 司, 太田 寿子, 三浦 正次, 宍戸 ...
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 172-
    発行日: 1983/02/20
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  • 辻 寧重, 安田 隆義, 西村 昭男, 櫛田 隆久, 比嘉 司, 熊谷 文昭
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 172-173
    発行日: 1983/02/20
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  • 高橋 弘昌, 高木 知敬, 佐々木 文章, 秦 混信, 内野 純一
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 173-
    発行日: 1983/02/20
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  • 閣下 芳明, 高橋 基夫, 川嶋 旭, 池永 和親, 敷波 敏明, 伊丹 儀支, 富樫 要
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 173-
    発行日: 1983/02/20
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  • 菊池 敵, 平開 敏憲, 久保 富男, 高橋 秀史, 西野 手郷, 小林 尚司
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 173-
    発行日: 1983/02/20
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  • 森田 嬢, 秦 温信, 内野 純一, 葛西 洋一, 武田 武夫
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 173-174
    発行日: 1983/02/20
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  • 辻 寧重, 安田 隆義, 西村 昭男, 櫛田 隆久, 比嘉 司, 熊谷 文昭
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 174-
    発行日: 1983/02/20
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  • 高木 知敬, 高橋 弘昌, 佐々木 文章, 中山 雅之, 大川 正人, 名取 孝
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 174-
    発行日: 1983/02/20
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  • 佐藤 綾子, 大島 宏之, 中島 進, 鮫島 夏樹
    原稿種別: 本文
    1983 年 19 巻 1 号 p. 174-
    発行日: 1983/02/20
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