岡山医学会雑誌
Online ISSN : 1882-4528
Print ISSN : 0030-1558
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123 巻, 1 号
選択された号の論文の13件中1～13を表示しています
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平成21年度岡山医学会賞受賞論文
総説
  • Renato Dulbecco：ダルベッコ培地
    難波 正義
    2011 年 123 巻 1 号 p. 27-31
    発行日: 2011/04/01
    公開日: 2011/05/02
    DOIhttps://doi.org/10.4044/joma.123.27
    ジャーナル フリー
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    現在，医学分野の多くの研究は培養細胞や培養組織を用いてなされている．それらの研究成果が報告されている論文の“材料と方法”の項で，ダルベッコ培地を使用して細胞を培養したといった記載を読んだ研究者は少なくないであろう．また，実際にダルベッコ培地を使用した研究者もいると思う．今回は，この培地を報告したDulbecco（1975年，がんウイルスの研究によってノーベル賞）の波乱万丈の経歴，彼の人脈（多くの人物がノーベル賞を受賞），彼の研究概略などについて紹介したい．そして，筆者のダルベッコ培地に対する見解とその培地を使用した経験について述べる．筆者の結論は，初代細胞培養にはダルベッコ培地が勧められること，また，培養細胞を用いての毒性検定に際しては，使用する培地によって結果が異なることがあるので注意する必要があることである．
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原著
  • 十二指腸潰瘍穿孔に対する治療法の適応についての検討
    石堂 展宏, 田村 竜二, 岡本 貴大, 門脇 嘉彦, 森 隆
    2011 年 123 巻 1 号 p. 33-38
    発行日: 2011/04/01
    公開日: 2011/05/02
    DOIhttps://doi.org/10.4044/joma.123.33
    ジャーナル フリー
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    Background: Although conservative therapy has been acceptable as the first-line therapy for duodenal ulcer (DU) perforations, surgical therapies are known to have certain advantages. We investigated the indications for laparoscopic (LS) or open surgery (OS) or conservative therapy (CoT) among 56 DU perforation cases over 5 years. Methods: 31 LSs, 22 OSs and 5 CoTs were analyzed for patient's physical and surgical factors and clinical course. Results: Mean age was 51.6. Male/female ratio was 49/9. Survival ratio was 98%. Although the hospital stay (10.9 vs 19.5 days) and analgesic administrations (1.9 vs 4.6 days) were significantly shorter in LS than OS, almost all OS patients were in serious condition as evidenced by longer waiting time before treatment, stronger pain, bigger hole of perforation, more ascites accumulation and higher morbidity of complications. Two cases of multisurgery were experienced in both LS and OS groups due to leakage of seam, abscess formation, relapsed ulcer or idiopathic intestinal perforation. LS is a therapy more widely usable and more beneficial than the other two. Conclusion: LS, a minimally invasive surgery for DU perforation, should be considered as a first-line standard therapy because of significant advantages such as shorter hospital stay. OS or CoT may be selected when appropriate.
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症例報告
  • 成人先天性胆道拡張症の6例
    高嶌 寛年, 佐々木 明, 佐々木 薫
    2011 年 123 巻 1 号 p. 39-43
    発行日: 2011/04/01
    公開日: 2011/05/02
    DOIhttps://doi.org/10.4044/joma.123.39
    ジャーナル フリー
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    We report six patients with adult congenital biliary dilatation treated by surgery. Of the six cases, five were female and the patients' age at diagnosis ranged from 19 to 51 years old. By Todani's classification for bile duct dilatation, three were categorized as Ia, one as Ib, and two as IVa. All six cases had anomalous arrangement of the pancreatobiliary duct. Resection of the cystic portion and hepaticojejunostomy (Roux-Y) were performed in all. After surgery, one patient classified as Ia and one as IVa had complications of cholangitis and intrahepatic stones. We removed the stones by the percutaneous transhepatic route with dilatation of the stenotic anastomosis, but cholangitis recurred in the IVa patient. Although surgical resection of the cystic portion and reconstruction of biliary tract is considered to be a standard treatment for adult congenital biliary dilatation, this IVa case had complications after surgical treatment. Thus short-term follow-up is necessary to prevent or diagnose stenotic anastomosis following the operation.
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  • 完全内臓逆位症に発症した胃癌の1例
    野間 和広, 田中屋 宏爾, 竹内 仁司, 小長 英二, 藤原 俊義
    2011 年 123 巻 1 号 p. 45-48
    発行日: 2011/04/01
    公開日: 2011/05/02
    DOIhttps://doi.org/10.4044/joma.123.45
    ジャーナル フリー
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    Situs inversus totalis (SIT) is a relatively rare congenital anomaly with a reported incidence of 1 in 5,000 to 10,000 live births. Although some reports of SIT with malignancy have been published, there have been few reports on SIT with gastric cancer or on the potential complications of surgical intervention in such cases. We here report the case of a patient who underwent surgical treatment for gastric cancer with SIT. The patient was a 54-year-old male, who had been an outpatient with chronic hepatitis and diabetes mellitus. He received an upper endoscopic examination for follow-up of esophageal varices and type 2 ulcerative gastric cancer was found at the posterior wall of the lower stomach. Biopsy was performed and the patient was diagnosed with moderately differentiated gastric cancer. Distal gastrectomy was performed with precise preoperative anatomical analysis in order to confirm that there was no another anomaly, such as cardiovascular or congenital anatomical anomalies except for the inverted position of all of the viscera. Adequate anatomical examination and analysis of the inverted position of related vascular for surgical treatment could lead to safer interventional treatment for malignancies with SIT.
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