Kunihiko Manabe

Spontaneous regression of hepatocellular carcinoma.

Abstract: A 62-year-old Japanese man with hepatitis B virus-related liver cirrhosis revealed α-fetoprotein (AFP) elevation. Dynamic computed tomography, taken at this time, showed a liver tumor in the anterior segment. As the patient refused any further medical treatment, he was observed in an outpatient clinic. The size of the tumor reduced and the serum level of AFP decreased gradually without any treatment. Twelve months after the initial diagnosis, the tumor could not be detected by computed tomography (CT) scan, and the level of AFP had declined to the normal range. Blood supply is essential for tumor growth and an arterioportal shunt near the tumor may change the dynamics of blood flow to the tumor. The shunt found in this patient was thought to be one of the causative factors leading to regression, but it could not be denied that immunological mechanisms may have played an important role in the spontaneous regression of hepatocellular carcinoma.

Establishment of an experimental model of human hepatoblastoma

Establishment of xenografts or cell culture lines in which the α‐fetoprotein (AFP) characteristic of clinical hepatoblastoma persists have been difficult. The serially transplantable strain (HB‐3) of highly AFP‐producing hepatoblastoma was successfully established in nude mice. And a highly AFP producing cell line (c‐HB‐3) is easily obtained by HB‐3. This strain and line give us an ideal experimental model of hepatoblastoma in vivo and in vitro. Cancer 50:97–101, 1982.

Primary Lung Cancer Occurring Concomitantly with the Cicatrized and Calcified Ova of a Parasite: Report of a Case

Abstract We report herein a rare case of primary lung cancer that occurred concomitantly with the calcified ova of a parasite. A 58-year-old man was referred to our department after a pulmonary abnormal shadow had been seen on a chest X-ray done at mass screening. A transbronchial lung biopsy (TBLB) revealed the calcified ova of a parasite. Because the possibility of concomitant lung cancer could not be ruled out, a lung biopsy was taken via video-assisted thoracic surgery (VATS). The pathological diagnosis was squamous cell carcinoma, and a left upper lobectomy was serially performed through a posterolateral thoracotomy. The patient recovered uneventfully and has remained in good health without any sign of recurrence for over 9 months. Following this case report, we review three other cases of this unusual disease combination documented in the literature.

A Case of Intestinal Obstruction Caused by Bezoar following a Pylorus-preserving Gastrectomy.

胃石による腸閉塞は比較的まれな疾患とされてお り,いったん発症すると保存的治療による治癒は困難 とされている. 近年胃癌に対する機能温存手術の 1つとして幽門保 存胃切除術が盛んに行われるようになってきており, この術式により術後のダンピング症候群が改善するこ とが明らかになってきている. 今回,我々は幽門温存胃切除術後に発症した柿胃石 による腸閉塞の 1例を経験したので,文献的考察を加 えて報告する. 症 例 患者:43歳,女性 主訴:腹痛,腹部膨満感 現病歴:1996年10月24日,胃体部領域,粘膜内癌, リンパ節転移(-)の胃癌に対して幽門保存胃切除術 を施行した.迷走神経の肝枝,幽門枝は温存した.術 後は上部消化管造影で胃からの排泄遅延もなく良好に 経過し,1996年11月13日に退院した.その後特記すべ き症状なく経過していたが,1998年 7 月頃より時々前 胸部痛が出現し,同年10月より食前の嘔気,食後の腹 部膨満感を伴うようになったため,10月27日当科を受 診した.胃内視鏡検査で直径約 3cmの胃石をみとめた (Fig. 1).生検鉗子での破砕摘出を試みたが,表面が硬 く,破砕は不可能であった.レーザー照射などによる 再度の内視鏡的破砕摘出術を準備するため自宅待機と した.11月15日より突然腹痛と嘔吐が出現したため, 11月16日当院を受診し,腸閉塞の診断で入院となった. 既往歴:特記すべき事項なし. 入院時現症:身長146cm,体重46kg.眼瞼結膜に貧 血,黄疸をみとめず.腹部は膨隆著明,下腹部に圧痛 をみとめたが,筋性防御をみとめなかった.腸雑音は 亢進していたが,機械音は聴取されなかった. 入院時検査所見:末梢血一般検査では白血球数が 10,620 mmと軽度上昇していた以外に異常所見をみ とめなかった.生化学検査においては肝機能,腎機能, 電解質はすべて正常値であった.血清アミラーゼは80 IU l と正常値であったが,CPKは470IU l と上昇して いた.CRPは0.3と正常範囲内であった(Table 1). 腹部X線写真所見:小腸の拡張像が認められたが, 鏡面像はみとめなかった(Fig. 2). 日消外会誌 33(11):1799~1801,2000年