Hiroshi Koitabashi

Snowboarding splenic injury: four case reports.

With the rapidly increasing number of snowboarders, the incidence of injuries has recently become higher. From 1994 to 1995, we encountered four snowboarders with splenic injuries in one season. In three of the four patients the splenic injuries were caused by striking the abdomen with their own elbow when falling by themselves, of which emergent splenectomy was required in two patients. In the other one the collision with another snowboarder caused the splenic injury and splenorrhaphy was performed. Because snowboarders have both feet fixed on a board and do not have poles, they are prone to fall on the left upper limb in the proceeding direction, resulting in the striking of the left upper abdomen. Because in snowboarders splenic injury is caused mostly by a blow from their own left elbow at the time of falling, informing the mechanisms of splenic injuries will serve a speedy correct diagnosis for the doctors.

Inhibitory Effects of Combined Administration of 5-FU and Krestin on Liver Cancer KDH-8 in WKA/H Rats

The effectiveness of the combined administration of 5-fluorouracil (5-FU) and Krestin (PSK) on experimentally induced liver cancer has not been established. This study was undertaken to elucidate the effect of the combined administration of these drugs on tumor growth and metastasis. Male inbred WKA/H strain rats were used. The drugs used were 5-FU and PSK, each dissolved in water and fed orally. The drugs were administered separately or concurrently in standardized cycles to the tumor-bearing animals. KDH-8 ascitic liver cancer cells were subcutaneously transplanted into WKA rats. The tumor growth inhibition rates of 5-FU and PSK were then determined. Eighteen days after subcutaneous transplantation, tumor growth in the combined administration group was significantly inhibited, compared to the control group and the single treatment groups (p < .05). In addition, a liver metastatic model was prepared by transplanting KDH-8 cells into the spleen. Then the metastatic inhibitory effects of 5-FU and PSK were analyzed. At 14 days, the mean number of liver metastatic nodules was approximately 63 in the control group. However, the combined-medicated group showed a much lower number of nodules (40), indicating that metastasis was significantly inhibited (p < .05).

A Rare Case of Huge Gastric Carcinoma with Extramural Growth

A rare case of gastric carcinoma which grew extramurally and invaded into the transverse mesocolon and pancreas is reported. The patient was a 67-year-old female, complaining of anorexia, weightloss and abdominal distension. She was diagnosed as gastric carcinoma with extramural growth. Intraoperative findings included a fistsized, elastic hard tumor on the greater curvature that infiltrated into the transverse mesocolon and pancreas head(S3P0H0N1 stage4). Histopathologically, it was diagnosed as a poorly differentiated adenocarcinoma. The main tumor invaded deeply into the subserosal soft tissue(10× 8.5 × 6.5 cm). However upper part of the tumor appeared on the mucosal surface as a small erosion(1.2×0.9 cm in diameter).

A Case Report of Anal Carcinoma Associated with Perianal Pagetoid Lesion

肛門周囲Paget病を伴う肛門癌は, きわめてまれな疾患であり, 本邦では今回われわれが経験した症例を含めて9例が報告されているにすぎない.症例は74歳男性であり, 肛門周囲の疼痛と腫瘤を主訴として入院, 皮膚生検の結果肛門周囲Paget病と診断された.さらに肛門癌も合併していた.手術は腹会陰式直腸切断術を行ったがすでに両凧径部リンパ節転移を認めた.術後, 会陰部創に対しては計20Gyの腔内照射, 嵐径部に対しては計14Gyの電子線照射を行ったが, 会陰部皮膚の再発なども合併して初回手術後6か月で死亡した.組織学的には, アポクリン腺原発汗腺癌であったが, 今回の症例は汗腺癌がPaget病変を合併した貴重な症例と考えられた.また, 従来いわれているように肛門周囲難治性皮膚湿疹では, Paget病などの存在を十分考慮した診断が重要と考えられ, 積極的な外科的治療が必要と考えられた.