昭和医学会雑誌
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
24 巻, 1 号
選択された号の論文の3件中1~3を表示しています
  • 今仁 剛正
    1964 年 24 巻 1 号 p. 1-21
    発行日: 1964/04/28
    公開日: 2010/09/09
    ジャーナル フリー
    In Japan, there is an attempt to establish some criteria for the surgical operation of stomach cancer patients in an effort to improve the distal result of operation.
    This author has participated in a conference to provide such criteria and is responsible to clarify their adequacy.
    In this connection, a total of 194 stomach cancer patients received Gastrectomy in the author's clinic during the 7 years period from 1956 to 1962 were employed in the present study and comparisons were made between the findings at the time of operation and postoperative distal results.
    According to the provisional criteria stated above, the operations which are free from any intraperitoneal dissemination, hepatic metastasis, cancerous adhesion to the surrounding organs, and those in which the removal of regional lymphnodes is complete sufficiently covering the scope of any possible metastasis, and also when the histological pictures of the each extremely of the removed stomach deny the presence of cancerous cells, they are called“curative operation”, while those which do not satisfy above criteria are called“non-curative operation”.
    First, when classified macroscopically by the surgical operator, out of the 194 cases of Gastrectomy stated above, 127 cases were curative operations and the remaining 67 were non-curative ones. On careful investigation of the histological preparations of their removed samples, additional 27 cases were transf ered from the group of curative operations to that of the non-curative ones. Because, the presence of cancerous cells at the end of the dissection was suspected in 22 cases and lymphatic metastasis was found in the other 5 cases.
    The 1 year survival rate of thus histologically corrected curative operations was 86 %, 3 years survival rate 59 % and 5 years survival rate was 62 %. The survival rates of non-curative operations were 25 %, 2 % and 0 % respectively.
    The findings stated above confirmed that the criteria employed in the classification of curative and non-curative operations of gastric cancer were in complete agreement with their distal results, and thus, it has been concluded that the operations of gastric cancer should be made to satisfy all the criteria of curative operations.
    Aside from the pathohistological conditions regulating curative operations, various biological characteristics of cancer, which have been claimed by a number of senior investigators to be closely related to the distal results, such as Borrmann's types, histological types of infiltration, extent of the cancerous infiltration into the gastric wall have also been confirmed to be significant for the judgement of distal results.
  • 松本 順一
    1964 年 24 巻 1 号 p. 22-38
    発行日: 1964/04/28
    公開日: 2010/09/09
    ジャーナル フリー
    The postoperative adhesion of the intestine is still the greatest trouble in the abdominal surgery.
    Recently, Dr. Wakisaka reported that the intraabdominal infusion of 1% Chondron liquid is efficient for the prevention of the intestinal adhesion and Dr. Yamanaka reported also the good effect of that of 7% P. V. P, for the some purpose.
    The author tried the same liquids in the animal experiment, but could not find the excellent effects as these investigaters had reported.
    Concequently the author tried other liquids as Silicone or changed the liquid concentration of Chondron or P. V. P. or at last used the mixed solution of Chondron and P. V. P. of different concentration.
    As the result one of the last methods (The infusion of the mixture of 1% Chondron and 7% P. V. P.) showed the most excellent effects in both animal experiments and clinical investigation. In the animal experiments the author used 47 of dogs and 39 of rabbits and examined the Specimens pathohistologically. In the clinical investigation he observed the clinical processes of 62 patients who were infused with the mixture by the relaparotomy according to the intestinal adhesion for 4 years from 1958 to 1962.
    Only 3 (4.8%) out of these 62 patients needed the third laparotomy, against the 11.1% of control group by whom the preventative method was not used by the relaparotomy with the same reason.
    So the author concluded the report in recommending the infusion of the mixture of 1% Chondron and 7% P. V. P. into the abdominal cavity at every laparotomy for the prevention of the intestinal adhesion.
  • 渡辺 嵩
    1964 年 24 巻 1 号 p. 39-55
    発行日: 1964/04/28
    公開日: 2010/09/09
    ジャーナル フリー
    The auther studied 21 patients of malignant tumor who had admission in the Showa Medical School Hospital in 2 years period from Oct. 1961 to Jul. 1963. They were treated with administration of massive Mitomycin-c in pre-operative or operation period. And auther tryed bone marrow transfusion in 17 patients who had leucopenia after the chemotherapy or radiation therapy for malignant tumors.
    Effects were following: -
    1) High frequency lung complication following pre-operativ massive treatment was found.
    2) In some patients of massive treatment in operation, suture insufficiency of intestine or abdominal wall was found, and experiments of dog, showed that the suture insufficiency was certeinly the side effect of Mitomycin-c.
    3) More effective treatment of leucopeny, after chemotherapy or radiationtherapy for malignant tumors was bone marrow transfusion than others. The transfusion into sternum gave beter effects than that into the elbowvein and leucocytes increased to the mormal level in 3-4 weeks. Cortisone was given in some cases without clear effects.
    4) The experiments with homogeneus bone marrow transfusion in dogs showed the beter effects with marrow than with vein.
    Cortison also gave no clear effects in the experimental transfusion in dogs.
feedback
Top