日本レーザー医学会誌
Online ISSN : 1881-1639
Print ISSN : 0288-6200
ISSN-L : 0288-6200
10 巻, 3 号
選択された号の論文の137件中1~50を表示しています
  • 早田 義博
    1989 年 10 巻 3 号 p. 1-4
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Lasers have been employed in various medical fields, such as photocoagulation therapy, high energy therapy, shock wave therapy, pho-todynamic therapy, low energy therapy and even acupuncture. Among these particularly significant developments were seen in photo-dynamic therapy and laser angioplasty. In the near future photodynamic therapy will bcome one of the main approaches to the non-surgical treatment of cancer, while diseases of the coronary artery will be treated with laser angioplasty, especially with photody-namic therapy. In future we intend to estab-lish National Medical Laser Center.
  • Giovanni Galletti
    1989 年 10 巻 3 号 p. 5-22
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
  • Timothy A. Sanborn
    1989 年 10 巻 3 号 p. 23-34
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
  • 新田 政博, 三好 憲雄, 中嶋 和喜, 内藤 克輔, 宮崎 公臣, 久住 治男
    1989 年 10 巻 3 号 p. 35-37
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    The cellular uptake of adriamycin (ADM) and hematoporphyrin derivative (HpD) Was investigated using a fluorescence spectrophotometer and KK-47 cells in vitro. Three types of combination of ADM and HpD,(1) ADM→HpD,(2)HpD→ADM, and (3) ADM+HpD, were studied in terms of cellular uptake and phototoxicity. The HpD uptake was large in order of (3)>(1)>(2). The cytotoxicity of ADM was thought to be inhibited by cellularly incorporated HpD in order of (3)>(1)>(2). When the cells treated with the 3 combination procedures were irradiated with an argon laser (488.0 and 514.5nm) or argon-dye laser (635+5 nm), the degree of cytotoxicity was large in order of (1)>(3)>(2). Particularly, with the argon laser, the degree was in order of (1)=(3)>(2).
  • 山本 有平, 大浦 武彦, 杉原 平樹, 小野 一郎, 松本 敏明, 皆川 英彦, 井川 浩晴, 野平 久仁彦, 浅見 謙二, 藤居 仁
    1989 年 10 巻 3 号 p. 39-42
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    The laserflowgraphy, was developed to visualize the skin blood flow, has been applied to measure the microcirculation in various angiopathy, avasculized skin and several types of skin flaps. These laserflowgrams were evaluated, and some of them were compared with the thermograms.
    The thermograms were under the influence of deeply influent arteries, on the other hand the laserflowgrams reflected the cumulative microvascular blood flow to the depth of the papillary dermis of the skin.
    It was noted that the microvascvlar circulation of the skin is displayed as the mottled pattern, is variably distributed, which was never found by means of the conventional laser flow meters that can measure the blood flow of only one spot in the observation area at one time.
    This laserflowgraphy can measure the skin blood flow noninvasively, quickly and sequentialy at any place, so it is very useful and practical.
  • 藤居 仁, 新家 真, 江口 秀一郎, 構倉 隆
    1989 年 10 巻 3 号 p. 43-46
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    A new instrument is developed to evaluate microcirculation in human retina. An infrared laser beam emitted from a laser diode transmits through a standard retinal camera and illuminates a part of retina. The laser spot is imaged onto an area sensor developed specially for this system, and the output video signal is digitized and stored in a mass memory. The difference between a pair of data for successive scannings of the speckle image is calculated and integrated for each pixel. The results are displayed in color graphics showing the spatial variation of the retinal blood flow in the area of interest.
  • 松永 隆, 佐藤 信紘, 江口 寛, 後藤 守孝, 福井 弘幸, 肱岡 泰三, 柏尾 真司, 永野 公一, 吉原 治正, 川野 淳, 鎌田 ...
    1989 年 10 巻 3 号 p. 47-49
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    We have developped a spectrophotometr ic method to monitor blood oxygenation in a disc-shaped area (17um in diameter) in a hepat ic lobule under in Vivo microscope.
    This system is useful for analyzing hepatic intralobular and intrasinusoidal oxygenation level heterogeneity in vivo.
  • 戸井田 昌宏, 近藤 真, 市村 勉, 稲場 文男
    1989 年 10 巻 3 号 p. 51-54
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    This paper repots and discusses for the first time the possibility for realizing an optical computer tomograpy for biological subjects using the optical heterodyne technique that has excellent sensitivity and directivity to distinguish one specific direction in highly scattering absorptive media. Employing an optical heterodyne system with a single frequency He-Ne laser, Lambert-Beer's law was demonstrated for directly transmitted beam even in highly scattering media such as milk-water solution and its mixed solution with absorptive dye. We discuss the detection system based on the antenna property of the optical heterodyne receiver for investigating the characteristics of laser beam propagation and its direction as well as image detection in highly scattering media.
  • 加藤 富嗣, 大池 康久, 臼井 幹雄, 中島 均, 浅原 孝之, 内藤 雄一, 山澤 〓宏, 伊吹山 千晴, 会沢 勝夫, 安中 ゆかり
    1989 年 10 巻 3 号 p. 55-58
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Accumulation of HpD and NPe6 as photosensitizer in atheroma, by the fluorescence of HpD and NPe6, were demonstrated. HpD or NPe6 were given to atheromatous rabbits. The accumulative patterns of HpD and NPe6 in the atheroma were observed. The localization of HpD and NPe6 were examined by fluorescence spectrum detector. Characteristic emission of HpD and NPe6 fluorescence with peak of 630,690 and 670nm wavelength were detected in the atheroma. The thickness of the intima and the height of the spectra had correlation. It was suggested that the analysis of fluorescent spectrum might be useful for identifying the atherosclerotic lesions.
  • 一居 誠, 三村 征四郎, 竜田 正晴, 奥田 茂
    1989 年 10 巻 3 号 p. 59-60
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Infrared (IR) laser endoscopy was applied to the diagnosis of the depth of invasion of early gastric cancer. The beam of IR laser produced by a krypton dye laser was led to the gastric lumen by the light guide bundle of a gastrofiberscope or by a fiber bundle through a foreceps channel of an electronic endoscope. The lumen was illuminated by the laster with an output of 200 to 400 mw at a wavelength of 805 nm. IR images were visualized on the TV monitor by an IR vidicon attached at the eye piece of the fiberscope or a CCD at the tip of the electronic endoscope. The vessels of the gastric wall were observed in positive image. Then, 1 to 5 mg/kg of indocyanine green (ICG) which had the maximum absorption peak at 805 nm, was injected intravenously to enhance the vascular network of the deeper layers.
    Fifty-four cases were examined by this method. The characteristic findings of IR laser endoscopy are as follows;(1) disappearance of normal vascular network with thin stain in mucosal carcinoma, (2) thick stain and pooling phenomena in submucosal one. Further, these are confirmed in part by endoscopic ultrasonography The method using the electronic endoscope was superior in the manipulation to that us ing the fiberscope and the IR vidicon, but more improvements were required in the quality of IR images.
  • 長澤 明範, 加藤 一一
    1989 年 10 巻 3 号 p. 61-64
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    The authors. basic experiment has revealed the interesting phenomenon that the optical and the thermal reaction of carious dental structures to the Nd: YAG laser beam is essentially different from that of normal dental structures depending on their optical charcteristics. The result of this experiment hopefuly suggested the possibility of the dental caries detection applying the photo-thermal reaction of teeth against the laser irradiation, and this study was designed to realize this suggestion.
    The basic method of this experiment was as follows: When a tooth crown surface was exposed to a very weak pulsed Nd-YAG laser shot, the surface temperature and the transmission of the laser in the tooth were measured with an infrared thermometer and the special thermocouples. These data were recorded simultaneously on a multi pen recorder with a pen offset compensator function. Comparative analysis on the data of carious teeth with that of normal teeth has revealed the dramatic result that carious teeth were clearly differentiated from normal teeth, and the affected area could also be observed with real-time thermography. This method is superior to conventional roentgenographic diagnosis for dental caries because of its complete safety and its high sensitivity for a fine primary caries that can not be detected by radiographic examination and it may lead to an exciting new dental caries examination.
  • 大道 雄一郎, 小峰 志訓, 荒井 恒憲, 稲崎 聡, 須田 亮, 菊地 眞, 中村 宏
    1989 年 10 巻 3 号 p. 65-67
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    To prevent a false irradiation to the surrounding urotherial tissue during stones laser fragmentation, we applied a new method, fiber-optic pulsed photo-thermal radiometry (PPTR), to discriminate between them. The experiments were made in vitro with wet stones and canine urotherial tissues irradiated by various lasers. The Ge-Se-Te glass fiber was used as a detection line. The ultraviolet Ar laser irradiation carried out better result than CO laser iradiation for the discrimination of the wet sample. The canine urotherial tissue was able to be clearly differential from the wet stones by the measurement of the e-folding decay time from the peak of the PPTR waveform.
  • -サーモグラムと急性鎮痛効果の相関について
    小幡 純一, 高橋 信夫, 柳瀬 昌弘, 本村 明江
    1989 年 10 巻 3 号 p. 69-72
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    The relationship of acute pain-relief effects of low power (Ga-Al-As Diode) laser irradiation and thermogram of 19 Rheumatoid Arthritis patients was examined. The maximum skin temperature (MST) level of 10 patients (52.6%) dropped immediately after irradiation. Laser treatment was effective in 90% of these cases. The MST level of 8 patients (42.1%) rose immediately after irradiation. Laser treatment was ineffective in 5 of 8 cases. The effective ratio of irradiation of patients whose MST levels dropped was statistically high. (P0.05) When MST levels rise, irradiation would be ineffective. The thermogram in cases at 10 minutes after irradiation showed no relationship to acute pain-relief effects of laser therapy.
  • 篠原 秀樹, 石井 正倫, 加藤 治文, 早田 義博, 會沢 勝夫, 黒須 良玄, 黒須 篤平, 石月 満
    1989 年 10 巻 3 号 p. 73-76
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    The authors investigated the effectiveness of laser stimulation therapy for pain by means of a gallium-aluminium-arsenide diode laser system in 358 cases concerms with pain and other symptoms. This stady low power laser (Helium-Neon laser) stimulation therapy in 398 cases: 128 skin & tissue defects, 72 burms, 67 fracture etc. The He-Ne laser emits a 8.5mw±20% beam of 632.8nm wavelength. The sites that were irradiated wound areas and painful areas. From this study the wound healing was accelerated by irradiation with low power laser.
  • -基礎的・臨床的検討-
    大西 清, 中島 龍夫, 吉村 陽子, 小林 雅明, 柴田 恭志, 米田 敬
    1989 年 10 巻 3 号 p. 77-80
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Low power laser irradiation has been shown to be effective in promoting wound healing. We studied low power He-Ne laser stimulation on wound healing experimentally and clinicaly. Round skin defect of 10mm in diameter were created on the both sides of ear of rabbits. They were divided in three groups and two of groups were treated using low power He-Ne laser irradiation at 1.3J/cm2. One group was point irradiation and the other was scanning irradiation. In the irradiated groups, skin defects were healed rapidly and neovascularization was created around the defects. Histological examination showed that process of wound healing was progressive obviously with minimal inflammatory changes. In clinical cases, laser irradiation was useful for the promotion of healing and some showed general effect of irradiation.
  • 動物実験と臨床応用
    小川 和昭, 森山 一郎, 酉園 浩文, 今給黎 泰二郎, 坂本 邦彦, 花牟礼 豊, 昇 卓夫, 大山 勝
    1989 年 10 巻 3 号 p. 81-84
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    To approximate incised skin wound using Nd: YAG laser in experimental animal studies of guinea pigs and clinical applications was attempted. The effect of this laser technique was compared in histology, tensile strength and macroscopic scar formation with a conventional suture technique. The advantages of this new laser technique were as follows: 1. uniformity; 2. low scar formation; 3. strong approximation; 4. rapid wound healing.
  • 河野 透, 葛西 真一, 小谷 裕美, 水戸 迪郎, 斉藤 孝成
    1989 年 10 巻 3 号 p. 85-88
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Of the patients with sciatica, osteoarthritis and others, 116 of 149 experienced pain relief with the low power laser irradiation (LPLI). To investigate the neuronal mechanism of the effects of LPLI, we analyzed the effects of LPLI upon neuronal activities of sensory nerve by neurophysiological studies. LPLI upon sensory nerve suppressed flexion reflex afferent induced cord dorsum potential as well as sensory nerve discharge evoked by noxious stimulation. These results suggested that the analgesic effects of LPLI might be caused by blockade of conduction in the sensory nerve.
  • 下山 直人, 堀 雄一, 渡部 士郎, 飯島 一彦, 水口 公信
    1989 年 10 巻 3 号 p. 89-92
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Extracellular recordings were made from dorsal horn neurons in the lumbosacral enlargement in rats anesthetized with halothane (0-8-1.0%). Effects of He-Ne (8.5 mW; 632.8 nm) low power laser irradiation on the dorsal horn neuron responses to subcutaneous injection of formalin(5-10%, 0.1ml) were evaluated. It was observed that the irradiation significantly reduced the formalin induced responses.
    The observed inhibition of dorsal horn neuron might explain the clinically alleged analgesia elicited by low power laser irradiation.
  • 山田 邦雄, 松井 寛夫, 蟹江 良一, 大塚 隆信, 服部 正広, 加藤 泰治
    1989 年 10 巻 3 号 p. 93-96
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    We have investigated biological effects of low power He-Ne laser on articular tissues from the following three aspects.
    1. In vitro laser-treated cartilage: Marked enlargement of Golgi apparatus in chondrocytes was observed electronmicroscopically, indicating acceleration of cellular metabolism.
    2. Normal osteoblasts in culture: Laser irradiation accelerated proliferation of cultured osteoblasts only in the sparse state.
    3. RA synovial cells in culture: DNA synthesis of cultured RA synovial cells was inhibited by laser irradiation.
    These results suggest that low power laser irradiation inhibits aberrant synovial proliferation of RA, and could promote bone and cartilage regeneration.
  • 小西 敏郎, 平石 守, 森 潔, 吉田 純司, 平田 泰, 三山 健司, 真船 健一, 出月 康夫
    1989 年 10 巻 3 号 p. 97-100
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Twenty two cases in early gastric cancer underwent the endoscopic Nd-YAG therapy. Since the eligibility of this treatment was restricted to those patients who accompanied severe disease for gastric surgery, the average age was 71.5 years old. Eight cases (36%) accompanied other synchronus or metachronous multicentric gastric cancer. No patient died from gastric cancer after the treatment and 4 patients survived more than 5 years. Because all small cancers less than 1 cm in diameter were perfectly cured with laser irradiation, the applicable lesions for this treatment should be limited to the cancer less than 1 cm in size. The use of the lateral-aiming or contact type probe, the early re-irradiation after the initial treatment and the combined laser irradiation with electrocautery will promote efficacy of the laser treatment.
  • 伊藤 克昭, 加納 知之, 中村 常哉
    1989 年 10 巻 3 号 p. 101-102
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    The long-term effect of endoscopic laser therapy for early gastric cancer as a local curative procedure was reported Sixty-six patients with endoscopicslly diagnosed early gastric cancer whose surgical risk was critical or who refused surgery were treated by either Nd: YAG laser or photodynamic therapy (PDT) or both. Curative effect of Nd: YAG and PDT was expected in lesions of superficially elevated mucosal cancer less than 20mm and well demarcated superficially depressed mucosal cancer less than 10mm. All the lesions in this category (11 elevated lesions, 13 depressed lesions) were completely eradicated and negative for cancer on follow-up biopsy for more than 12 months. Risks of lymphnode metastasis in these lesions are reportedly minimal as well. Therefore, we conclude that the endoscopic laser is the treatment of choice for early gastric cancer as a local curative procedure in the aged if they have a curable lesions as mentioned above. However, it is so difficult to control the lesions beyond this category that further advances of laser medicine are needed.
  • 三村 征四郎, 一居 誠, 奥田 茂
    1989 年 10 巻 3 号 p. 103-104
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Thirty-eight early gastric cancer in 35 patients and two advanced ones considered poor risks for surgery were treated with HpD photodynamic therapy (HpD-PDT). The stage and depth of cancer was assessed by endoscopy. These 37 patients are consist of 26 males and 11 females. The distribution of ago was from 54 to 87 with a mean of 71 years old. Their follow-up periods ranged from one year to seven years and one month (Table 1) Three mg/kg of Photofrin I or 1.3-2.5mg/kg of Photofrin II was in jected intravenously, and about 50 hours later, the entire lesion plus a 5mm width of marginal mucosa was irradiated with an argon dye later through a single quartz fiber. The irradiation was delivered at 300mW·5 minutes/cm2, which gave a total dosage of 90 joule/cm2(Table 2 and Fig.1). Among these 38 early gastric cancers, 36 were treated with HpD-PDT alone, and local cure was obtained in 13 (59%) out of 22 mucosal carcinomas, and in 8 (57%) out of 14 submucosal ones (Table 8). The lesions which could not be cured with the initial HpD-PDT were t rooted with hot biopsy with electrodiathermy for a small remnant of cancer, or were repeat ed HpD-PDT once more for a wide one. The other two cancers out of 38 were done with HpD-PDT plus hot biopsy in an initial treatment, and local cure were obtained in both. The final cure rate ac cording to the depth of cancer, was 20 (90%) out of 22 in mucosal cancer, and was 10 (63%) out of 16 in the submucosal ones (Table 5). The advanced ones could not be cured with this therapy. Acording to the size of lesion scaled by cm2, the final cure rate of the size of smaller than 3 was 18 (90%) out of 20, that of 3 to 10 was 10 (71%) out of 14, and that of bigger than 10 was two out of four (Table 4). Looking over them by the gross type, the cure rate in elevated type was 7 (88%) out of 8, that of depressed type without ulceration was 11(73%) out of 15 and that of depressed type with ulceration was 12(80%) out of 15 (Table 6). The use of HpD-PDT should be confined t o an early stage, especially the depressed type and the assembled from of superficial elevated type. The protruding type and solitary elevated type can be cured by other methods such as electrodiathermy, Nd: YAG laser with little difficulty. Concerning the relation between dose and response, local cure was obtained with a dosage of more than 60 joule/cm2 in mucosal carcinoma, and with that of more than 72 joule/ cm2 in submucosal one (Fig. 2). The indication of HpD-PDT is firstly early gastric cancer in poor risk cases, secondly the superficial depressed type and assembled form of superficial elevated type, and thirdly the size of which should be smaller than 10 cm2(Table 8).
  • 原田 一道, 岡野 重幸, 村上 雅則, 北守 茂, 柴田 好, 岡村 毅与志, 並木 正義
    1989 年 10 巻 3 号 p. 107-108
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    We have experienced 61 early gastric cancer cases (inpatients, 64 lesions) using endoscopic YAG laser, I type: 1.0 cases, IIa type: 32 cases, IIc type: 21 cases,IIa+IIc type: lease. All patients have not taken surgical Operation due to some kinds of reason.
    We could observed 23 cases of no relapse over 5 years.
    Small size (below 2cm) elevated losion (IIa type) is good indication for laser therapy. IIc type of size below 1cm and no ulces is treated completedly. Histologically well-differentiated adenocarcinoma is good indicaked.
    Laser therapy combined another endoscopic therapy is effective for improving the quality of life in patients with nonresectable advanced cancer of the G. I tract. We will describe several advantages of laser ballon for clinical cases.
  • 山本 秀樹, 河手 典彦, 古川 欣也, 池田 徳彦, 伊藤 哲思, 玉地 義弘, 日吉 利光, 鬼頭 隆尚, 小中 千守, 加藤 治文, ...
    1989 年 10 巻 3 号 p. 109-112
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Recently, there are so many chances to find out the early stage lung cancer, because of the raising efforts for discovering the lung cancer and the wide spread usage of sputum cytological examination. Of course, the surgical therapy should be the first choice for these cases, but the inoperable cases are increasing due to the aging, low pulmonary function and severe complications.
    We have performed photodynamic therapy (PDT) in 40 cases of early stage lung cancers (45 lesions) during this 9 years. In these cases, 26 cases were disease free in 14 to 104 monthes after the PDT. But 4 cases were revealed the recurrence of cancer.
    In this paper, we examine the indication of the PDT for the early cancer.
  • 和志田 裕人, 渡辺 秀輝, 野口 幸啓, 佐々木 昌一, 加藤 誠
    1989 年 10 巻 3 号 p. 113-116
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Transurethral laser destruction using contact Nd: YAG laser (TULD) was performed on 70 occasions in 44 patients with primary bladder cancer for the purpose of cure from February 1984 to August 1987. In the 70 occasions, indication of the TULD was evaluated, and we never experienced diturbance of the ureteral orifice and the intra-mural ureter, and obtulator reflex. The cancers were classfied and staged in accordance with the Japanese Urological Association. The indication of the TULD was judged by surgeons with criteria as follows: degree of difficulty of manipulation, degree of destruction of the cancers, and bleeding during the TULD. Features of the cancers, for which the TULD was judged as suitable, were summarized as follows: 1.0n cystoscopical findings, the form of the cancer was superficial, the number of cancers were under the number of four and the sizes of the cancers were under 3cm in diameter. 2.0n pathological findings, the grade of the cancers reached grade II and the stage of the cancers reached stage T1. It may be concluded that the indication of TULD would be similar to TUR-Bt, but TULD might be superior to TUR-Bt from the points of view of damage of the ureteral orifice and obtulator reflex.
  • 阿部 裕輔, 今西 薫, 米沢 卓実, 鎮西 恒雄, 鈴川 正之, 丹羽 真一郎, 四谷 幸朗, 祖川 伊知朗, 上宮 崇文, 金沢 進一, ...
    1989 年 10 巻 3 号 p. 117-120
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    We have been developing coronary laser angioplasty system with excimer laser. And the coronary laser endoscopic system has been developed to realize visual coronary laser angioplasty.
    In order to design the coronary laser endoscopic system, various kinds of endoscope were developed experimentally and evaluated with animal experiment using goat to establish the requirement for the coronary laser endoscope.
    The requirement for coronary laser endoscope was clarified to be as follows:
    1, Diameter: 1.5-1.8mm max (goat, 50kg)
    2, Flexibility of the tip: flexibility is required and the combination of guide wire is useful for the successful coronary approach with endoscope.
    3, Stiffness of the body: stiffness is required for the better handling.
    4, Image fiber: 2000 pixel is possible. Light guide: good
    5, Bending function of the tip: 4 direction (at least 1 direction)
    6, Cannel: 1 channel for the guide wire and laser fiber passage.
    In present time, the bending function of the tip to 4 direction is not developed yet, and the technique of bending mechanism is being studied.
  • 荒井 恒憲, 水野 杏一, 須田 亮, 桜園 真己, 岡本 安裕, 宮本 明, 中川 眞人, 菊地 眞, 里村 公生, 五十嶋 一成, 栗田 ...
    1989 年 10 巻 3 号 p. 121-124
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    The animal experiments which used CO laser under intra-vascular visualization by a thin angioscope in viva is described. We developed a 6F laser angioscope catheter which had a tip steering capability by the combination of one-directional bending and rotation. We also developed a thin fiber cable which was covered by thin SUS tube with a round shaped ZnSe contact tip. These catheter and cable made it possible to get a fine contact of the tip. The condition of the contact to lesion was easily checked out by angioscopic observation of scattering materials which were generated by CO laser contact irradiation.
  • 岡林 均, 荻野 均, 岡本 好史, 伴 敏彦
    1989 年 10 巻 3 号 p. 125-127
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    We carried out a study on the possible application of the excimer laser in laser angioplasty. In the first experiment, the ablative effects of the excimer laser at the wavelengths of 248 nm (KrF) and 308 nm (XeCl) on the pig myocardium were examined in vitro at an air-tissue interface. Very clear cuts were observed on the histological examination. There was no evidence of thermal damage. In the second experiment, the excimer laser was coupled to a 400 μm quartz optical fiber. Laser angioplasty was performed in 4 totally occluded femoral arteries in mongrel dogs using the excimer laser (XeCl: 308 nm). The arteries were successfully recanalized in all 4 arteries using 2.5-6 mJ/pulse, 20-30 pps and 6000 shots.
  • 長田 一仁 , 河内 賢二, 清水 剛, 阿久津 博三, 石丸 新, 古川 欽一
    1989 年 10 巻 3 号 p. 129-130
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Contact laser thermal angioplasty with metal hot tip by argon laser (Trimedyne Inc. USA) was performed on 28 vessels of 24 patients from arteriosclerosis obliterans (ASO).
    The initial success rate of the laser angioplasty was 85.7%. Clinical success was defined as an improvement in symptoms and increase in the ankle pressure index in all of these patients.
    There was no perforation of arterial wall caused by laser thermal ablation with a metal hot tip heated by repeat pulses under a power condition of 10 watts of argon laser energy for 5 seconds.
    And in 20 vessels for one year follow-up period of successful 24 vessels, one year patency rate was 85%. No significant complications were observed during laser angioplasty without local dissection of the arterial wall after balloon dilatation.
  • 吉田 正人, 岡田 昌義, 辻 義彦, 中村 和夫
    1989 年 10 巻 3 号 p. 131-134
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Kobe University School of Medicine, Department of Surgery, Division II Experimental studies have been carried out to evaluate the safety and efficacy of recanalization for occlusive arterial disease by Argon laser using the bare-ended probe (BEP) and the metaltip probe (MTP) in our department.
    The efefects on vascular tissues to the laser was investigated using human cadaveric aorta. Temperature of the laser probe was very important factor for arterial recanalization. It was clearly considered that optimal conditions using MTP varied according to the probe size, and the smaller MTP was more effective on plaque under the same conditions of laser energy. Laser angioplasty with angioscopic guidance reduced perforation rate using BEP, and angioscope was useful for the observation of the newly recanalized channel by lasing.
    In addition, percutaneous transluminal laser angioplasty was successfully performed in 17 patients with severe intermittent claudication and rest pain or ulcer on legs. In conclusion, it could be considered that laser angioplasty might be a useful treatment for the occlusive diseases of the peripheral arteriels.
  • 竹川 鉦一, 淀野 啓, 佐々木 泰軸, 三浦 学, 西 直子, 木村 環, 青木 昌彦, 野田 浩, 佐々木 幸雄
    1989 年 10 巻 3 号 p. 135-138
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Percutaneous transluminal laser angioplasty was carried out on 59 occasions. Nd: YAG laser was used.
    In case of contact method with a ceramic tip, 15 to 20 W was applied for one to 2 seconds, during flushing with normal saline. The procedure was repeated until a desired effect is obtained. A bare laser fiber was also used.
    The initial success rate was 86.4%.
    The patency rate of the iliac artery was 88.9%, and that of femoropopliteal artery was 74.9%. PTLA of tibial or peroneal artery was also successful in 5 cases.
    Vascular endoscopy was useful in assessing the nature of arterial occlusive disease.
  • 加藤 隆弘, 奥田 順一, 井田 和徳
    1989 年 10 巻 3 号 p. 139-142
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Early gastric cancers (97 lesions with 86 cases) of high surgical risk were treated under endoscopy in 1981 to 1989 in our institute.
    Indication of endoscopic treatment for ealrly gastric cancer was divided into three groups. The first group belongs to the lesion of radical cure, what we call absolute indication. The second group is relative indication-carried out to over 75 aged patients or to patients with no wish for operation. The last one is a case of high surgical risk or rejection for operation.
    We think we should first choose mucosal resection method in the treatment of early gastric cancer, followed by various kinds of tumor destructive modalities (laser, microwave, ethanol local injection etc) if the case is in difficulty in delineation of the cancer lesion or wide spread or invasion into submucosa or accompanied with ulcerative change.
    But we have to investigate in many aspects furthermore to achieve complete irradication of early gastric cancers.
  • 高橋 寛, 藤田 力也, 杉山 圭一, 鈴木 悟司, 光銭 健三, 関 盛仁, 佐竹 儀治, 菅田 文夫, 生田目 公夫, 鈴木 快輔
    1989 年 10 巻 3 号 p. 143-146
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Twenty-nine cases of early gastric cancer were treated endoscopically by Nd-YAG laser irradiation and combination with endoscopic mucosal resection therapy. The cases indicated because of high risk for surgery were as followed; one lesion of type I eary gastric cancer, 8 lesions of type IIa, 17 lesions of type IIc, 3 lesions of type IIa+IIc.
    7 lesions of the protruted type, I, IIa, and one lesion of depressed type, IIc were underwent combination therapy procedures. The lesion has disappeared in 7 out of 8 lesions. Local relapse occured in 1 case because of invasion into submucosal layer.
    5 lesions of protruted type, IIa, IIa+IIc, and 16 lesions of depressed type, IIc were treated by Nd-YAG laser irradiation. 15 out of 19 lesions were destroied by laser therapy only, but local relapse was observed in 4 patients, in whom poorly differentiated adenocarcinoma and submucosal invasions were noticed. In such a high risk patients, we tried local injection of immuno-activating agent (ok-432) by endoscopically. 2 lesions, which were over 2 cm in diameter and submucosal invasions were treated. These patients were followed for 18 months, no relapse was occured until now. Among other early gastric cancers, endoscopic treatment is indicated for differentiated adenocarcinoma which are less than 2 cm in size and confined with the mucosal layer.
  • 原田 寛, 大曲 和博, 犬丸 雅比古, 池園 洋, 佐々木 英, 豊永 純, 谷川 久一
    1989 年 10 巻 3 号 p. 147-150
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    In Kurume University Hospital, follow-up study more than 1 year in the endoscopic Laser therapy for early gastric cancer (34 leseions, 26 cases) was analysed on the size and endoscopic features of lesions.
    Disappearance rate of cancer cells seemed higher in the protruded type and/or small lesions than the depressed and/or large ones after initial Laser irradiation. Cancer cells was detected in none of protruded lesions less than 10mm in diameter.
    These findings suggested that the endoscopic Laser therapy would be a curative therapy in these cases. Moreover, additional Laser irradiation was effective in the case of recidual cancer cells.
  • 嶋尾 仁, 比企 能樹, 小林 伸行, 山尾 哲彦, 上野 聰一郎, 東 博, 加藤 康行, 三重野 寛喜, 榊原 譲
    1989 年 10 巻 3 号 p. 151-154
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Thirteen cases of early gastric cancer which had over 1.5cm in diameter and/or submucosal invasion and/or with ulcerative changes were treated by YAG-Laser plus OK-432 (one of Biological Response Modifier: BRM) injection endoscopically
    Of the patients four were over 80 years old, other 9 patients had heavy concurrent diseases.
    Macroscopic classification of the gastric cancers were as follows; IIc 5 cases, IIc+III 6 cases, IIa one case and III+IIc one cases.
    Four invased only in mucosal layer and the others invased in submucosal layer endoscopically.
    OK-432 was injected 10KE around a laser ulcer in 1-2 times per week totally 80KE-200KE (10KEX8-20).
    In 8 cases of them, biopsies were negative by endoscopic controlls in 3-62 followed months (mean 16 months). One patient refused treatment on the way. One was operated because of new lesion, one was died by concurrent disease during the treatment period. Two were re-treated because of local recurrence.
    Though our small group and short follow up period, we think this combined method is useful for inoperable early gastric cancer.
  • 恒川 洋, 杉原 真, 篠田 昌孝, 間宮 均人, 笹野 陽子, 陳 建彰, 伊奈 研次, 森瀬 公友, 渡辺 喜則, 恒川 力
    1989 年 10 巻 3 号 p. 155-158
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
  • 岡村 治明, 加部 吉男
    1989 年 10 巻 3 号 p. 159-161
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Materials: Forty-seven patients with malignant gastrointestinal tumors have been treated by using Nd-YAG laser irradiation. These cases were 12 esophageal cancers, 29 gastric cancers and 6 rectal cancers.
    Method: Nd-YAG laser irradiation was performed by non-contact method. Irradiation time was 1 second at interval. The power ranged from 40 to 80 watt.
    Indications: Indications of Nd-YAG laser irradiation were as follows
    (1) Gastrointestinal stenosis in inoperable patients and local recurrence (Group A), (2)
    Poor risk and eldrely patients (Group B), (3) Patients who rejects surgical operation (Group C).
    Group A consisted of 24 cases (9 esophageal cancers, 12 gastric cancers, and 3 rectal cancers), Group B 14 cases (1 esophageal cancer, 10 gastric cancers and 3 rectal cancers) and Group C 9 cases (2 esophageal cancers and 7 gastric cancers).
    Results: Excellent results were obtained in 16.7% and good results in 33.3% in group A. Symptom disappeared in two of three patients with large intestinal obstruction. Excellent result were obtained in 50% and good result in 14.3% in group B. Excellent result were obtained in 33% and good result in 11% in group C.
  • 井戸 健一, 澁澤 公行, 大谷 雅彦, 熊倉 泰久, 市山 雅彦, 川本 智章, 木村 健
    1989 年 10 巻 3 号 p. 163-165
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Innovative peritoneoscopic methods for treatment of gallstones fail to deal with the underlying problem of an abnormal gallbladder but do result in a rapid return by the patient to preoperative function. Peritoneoscopic laser cholecystectomy was developed in an attempt to create a minimally invasive yet definitive method of dealing with cholecystitis and cholelithiases. The method, as developed in the canine model under laparotomy was presented. It involves Nd-YAG laser and Surgiclip®technology under general anesthesia.
  • 雨宮 隆太, 坪井 正博, 斎藤 宏, 松島 康, 於保 健吉, 早田 義博
    1989 年 10 巻 3 号 p. 167-170
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Between April 1980 and May 1989, a total of 117 cases of primary lung cancer and primary tracheal cancer were treated by bronchoscopic Nd-YAG laser vaporization. Effectiveness was observed in 43 of 46 cases of involving into the area from trachea to main bronchi, 48 of 71 cases of bronchial lesions.
    In 40 cases presenting with severe respiratory distress the procedure was performed as an emergency life-saving procedure and dramatic improvement in condition was seen in 37 cases (92.5%).
    In 5 cases of endoscopical early stage squamous cell carcinoma in which vaporization was performed as a radical curative procedure, no reccurence has been observed in 3 cases at 48-65 months.
    In 57 cases of advanced lung cancer which the procedure was performed as part of a combined therapeutic strategy, effectiveness was observed in 40 cases (70.2%).
    In effective cases following laser treatment for ventilatory disturvance, the patients' condition improved to the externt that chemotherapy or radiotherapy could be performed.
  • 鈴川 正之, 阿部 祐輔, 鎮西 恒雄, 米沢 卓実, 河野 明正, 満淵 邦彦, 井街 宏, 藤正 巌, 渥美 和彦
    1989 年 10 巻 3 号 p. 171-174
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    In order to realize percutaneous spinal surgery under the visual field, we have studied on the intraspinal surgical procedures with laser using a newly developed small diameter laser endoscope. The subarachnoid and epidural space of a goat was punctured and the endoscope (diameter 1.5 mm) was inserted through a needle. The spinal cord, nerve roots and the arachnoid were clearly observed as well as the pulsation of an artery surrounding a root. Then excimer laser was irradiated to a nerve root through 0.4mm laser fiber passed through this endoscope. The nerve root was cut within 30 seconds by excimer laser. It was demonstrated that this endoscope could become a useful diagnostic and therapeutic tool, although further improvement of the bending ability of the tip of the endoscope is necessary.
  • 柚木 俊一, 篠原 一彦, 出月 康夫, 橋本 大定
    1989 年 10 巻 3 号 p. 175-178
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    The endoscopic Nd-YAG LASER irradiation therapy has been utinized in the treatment of upper GI cancers. There is lacking, however, of the suitable LASER irradiation modality for intestinal cancers, due to the danger of perforation with the existing LASER therapy. To overcome this problem, we made a new LASER irradiation device, “Circulating Water Balloon LASER irradiation system”, and reported that we were studying its characteristics for clinical application. The character of this system is moderate coaguration without unfavorable tissue vaporization. In this time, we examined this system on the colon of dogs, and continuously measured the temperature of 37 points on the serosa during LASER irradiation. Compared to the results given from the conventional modality, more moderate coaguration was achieved without unfavorable perforation. And the balance of temperature was able to been maintained by the cooling effect of this system. Tissue coaguration could be limited to sm-layer or pm-layer, even to the trans mural coagulation was possible by using this system. In addition, with low powered irradiation, it worked as “LASER thermia”. So, we concluded that more precise and safer LASER therapy for intestinal cancers would be possible.
  • 西福 幸二, 二ッ木 浩一, 竹内 信良, 山本 邦男, 神田 裕三, 上原 敏敬, 関口 芳男
    1989 年 10 巻 3 号 p. 179-181
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    In November, 1988, we reported to the meeting of the 9th Japan Society for Laser Meidcine 1), which uses a balloon filled with a light scattering substance. We named. this method balloon laserthermia
    We investigated the optical and the thermal properties of the substance. And then, using the balloon of a 30mm diameter sphere, filled with 0.25% fat emulsion (Intralipid 20% drops), we got good results by the investigation of the balloon laserthermia on transplanted Meth-A sarcoma, with the laser power of 20 watts.
    However, if we use the another size of balloon, it seemed that the size was closely connected with not only the density of the light scattering solution but the laser power. Therefore, we investigated the relationship between the size of balloon, the density of the solution, and the laser power.
    The results showed that the smaller size of the balloon needed the higher density of the solution, but the lower power of the laser.
  • 中島 均, 山澤 〓宏, 楽得 博之, 臼井 幹夫, 浅原 孝之, 加藤 富嗣, 白石 祐盛, 亘 章, 内藤 雄一, 伊吹山 千晴, 高橋 ...
    1989 年 10 巻 3 号 p. 183-186
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    This study was performed to check the possibility of angioscopy and laser angioplasty of obstructive arterio-venous fistula. Dogs with the femoral arterio-venous fistula produce experimentally were divided into two groups. For producing thrombus, Group C dogs were inserted copper coil into the femoral vein. Group S dogs had the stenosis ligated in the femoral artery. Angioscopy and laser angioplasty was conducted for coil thrombus detected by angiography of the fistula. After performing angioplasty, angioscopy and angiography was conducted again. In Groups angioscopy was performed for 5 hours every one hour. After confirming safety of angioscopy experimentally, angioscopy was applied to the patients with obstructive arterio-venous fistula.
    Red thrombus in Group C, white fibrin net in Group S, and thickening of the intima of the patients was safely observed using angioscopy. Experimental laser angioplasty was safely performed and recanalization was confirmed by angioscopy and angiography.
  • 佐野 文男, 真鍋 邦彦, Hiroshi SHIROTO, 和田 耕一, 近藤 征文, 西田 修, 内野 純一
    1989 年 10 巻 3 号 p. 187-190
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    In experiment in vitro, PDT(HpD-Argon dye laser) was performed for HC-4 liver tumor cells (cultured human liver tumor) in the medium with HpD. Remarkable cytocydal effect was obtained by PDT with an efficient difference.
    In experiment in vivo, using the HC-4 liver tumor bearing nude mouse, severe tumor necrosis was observed without damage of surrounding tissue and no tumor growth was resulted.
    in experiment of PDT for the normal liver tissue, spherical tissue necrosis of about 10mm in diameter was observed after PDT following 60 minutes after HpD administration.
    As a result, clinical application of PDT for malignant tumor of the parenchymal organs would be supported.
  • 古川 欣也, 平野 隆, 山本 秀樹, 小中 千守, 林 永信, 加藤 治文, 河辺 博文, 会沢 勝夫, 早田 義博
    1989 年 10 巻 3 号 p. 191-193
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    We demonstrated last year that HpD accumulated large amounts in the both of ascites and ascites tumours of Balb/c ascites mouse and had cytocidal effects against the tumour cells. Then, we attempt to perform PDT using hematoporphyrin esters (HpE) to the pleural effusion type lung carcinoma to control the effusion, But the patient died of pulmonary failure, so we had to abandan to perform PDT, However we took specimens from the effusion, the lung carcinoma and the other organs. We compared the accumulation of HpE to the pleural effusion from the other organs. HpE accumulated in pleural effusion 3 times greater than in normal lung tissues at 48 hours after HpE injection. The result indicates that it may be possible to control malignant effusion of clinical case by PDT.
  • 坂本 優, 伊藤 良弥, 室谷 哲弥, 杉田 道夫, 杉下 匡, 天神 美夫, 藤原 宏, 高山 修一, 細野 佐芙郎, 平野 達, 本間 ...
    1989 年 10 巻 3 号 p. 195-198
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Recently, the incidence of CIS and dysplasia of the uterine cervix is increasing among young women. On that occasion, endocervical conization is often performed as a therapeutic method which can preserve the uterus. However, it may cause cervical stenosis or decrease in cervical mucus and develop sterility. Photodynamic therapy using Excimer Dye Laser which is more penetrative than Argon Dye Laser was applied to the two cases of CIS and four cases of dysplasia of the uterine cervix after basic research on EDL. As a result, photodynamic therapy using EDL could kill cancer and dysplastic cells selectively without damage to the normal cervical glands
  • 金子 貞男, 北川 道生, 寺坂 俊介, 藤岡 保範
    1989 年 10 巻 3 号 p. 199-202
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    A stereo tactically applied PDT was performed in the 64 year old male with metastatic brain tumor from lung Carcinoma.
    48 hours of ter 3mg/kg HPD administrations, optical fiber was inserted into four regions to photoradiate the whole tumor for the total dose of 1176 joules (250mw×20mins×4) using Kornai stereotactic apparatus.
    The patient died 28 days of ter PDT because of other disease.
    Autopsy was done and autopsy brain was showed as follow 1) Most of tumor cells were changed coagulation necrosis, but a small part of tumor was still alive.
    2) Tumor dose to make necrosis of the tumor volume composed of sphere about 7mm in diameter corresponding to the theoritical volume of light diffusion at the tip of the optical fiber was for 20 minutes, 250mw (300 joules), 630nm argon dye laser. 3) Therefore, some technical improvement is required to thorughly photordiate the tumor.
    PDT can be used as an adjuvant to conventional therepy.
  • 森山 一郎, 西園 浩文, 小川 和昭, 昇 卓夫, 大山 勝
    1989 年 10 巻 3 号 p. 203-204
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    Photodynamic therapy (PDT) is one of the promising methods of cancer treatments. We used pheophorbide-a as a new photosensitizing agent and Q-switched Nd: YAG laser in which could be used as a laser beam. Pheophorbide-a is one of the derivatives origined in chlorophyll and has been reported biologically as safe and useful ones. The two main peaks of UV spectrum of Pheophorbide-a were seen at 410nm and 680nm. FlEp-2 cells, which were established from epidermoid carcimoma of human larynx, were used for PDT. PDT significantly inhibited the cell growth and additional effect with hyperthermia was recognized.
  • 堀田 総一, 樫村 博正, 平井 信二, 蔡 承熹, 対馬 健祐, 中原 朗, 福富 久之, 大菅 俊明
    1989 年 10 巻 3 号 p. 205-208
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    In attempt to obtain basic data for endoscopical photochemotherapy (PCT) in combination with hyperthermia for gastric cancer, we investigated cytocidal effects of the combined treatment using a human cervical carcinoma (HeLa).
    To test whether the order of the hyperthermia and PCT has any influence on the cytocidal effect of the combination therapy, hyperthermia (44°Cfor 15 min) was performed either before or after irradiation with argon laser (514.5nm).
    The results indicate that cytocidal effects of PCT was potentiated by heat when the cells were heated after PCT, not when the cells were heated before PCT.
  • -アルゴン色素レーザーとの対比-
    川本 智章, 井戸 健一, 大谷 雅彦, 熊倉 泰久, 木村 健, 佐藤 治男
    1989 年 10 巻 3 号 p. 209-212
    発行日: 1989年
    公開日: 2012/09/24
    ジャーナル フリー
    A pulsed gold vapor laser (627.8nm) was experi-mentary compared with a continuous wave argon-dye laser (630nm) in terms of photodynamic effects on cultured hepatocellular carcinoma cells (JTC-16). The photodynamic effects on the cells were evaluated by a phase contrast microscope and erythrosine B exclusion test at 24 hours after laser irradiation. The porphyrin examined was hematoporphyrin.
    Gold vapor laser was more effective than argon-dye laser on the cells, when the concentration of hematoporphyrin was 15μg/ml. Photodynamic effects of laser would be due to photochemical response, since laser irradiation did not elevate the temperature of culture medium.
    This result support the superiority of gold vapor laser in photodynamic therapy
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