岡山医学会Acta Medica Okayama0030-155812222010当院における下部胆管癌手術症例の治療成績189194ENRyosukeHamanoMasaruInagakiManabuNishieNaoyukiTokunagaYosukeTsunemitsuShinyaOhtsukaKazuhideIwakawaHiromiIwagakiHiroshiSonobeWe experienced 20 patients with distal bile duct carcinoma from May, 1997 to December, 2007. The male/female ratio was 11/9 and the average age was 69.6 years. The operative procedures were as follows：pancreaticoduodenectomy (PD), 9；pyrolus preserving pancreaticoduodenectomy (PPPD), 8；subtotal stomach preserving pancreaticoduodenectomy (SSPPD), 2 and hepatico-jejunostomy without resection, 1. We performed a clinicopathological study on 16 patients with distal bile duct carcinoma, excluding 3 operation-related deaths and 1 unresectable case. The cumulative survival rate was 70% at 3 years and 11% at 5 years. The 3-year survival rates at fStageⅡ, fStageⅣa and fStageⅣb were 100%, 80% and 0%, respectively. Log-rank analysis revealed that pathological pancreatic and duodenal invasion and curative resectability may be prognostic factors, while lymph node metastasis and perineural and stump invasion did not affect prognosis. Six recurrences in the 11 curative resection cases (54.5%) were observed；therefore, postoperative systemic chemotherapy is warranted to curtail recurrence in advanced distal bile duct carcinoma.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010第109回 岡山医学会総会183187ENOkayama Medical AssociationNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010第171回 岡山外科会177182ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010西宮渡辺病院175176ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010中町赤十字病院173174ENNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010半田中央病院171172ENYujiHiramatsuNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010利益相反とコンプライアンス169170ENYujiHiramatsuNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010薬物相互作用（18―降圧薬の薬物相互作用）163167ENToshiakiMiyazakiAtsumiNishikoriHisashiMatsunagaToshiakiSendoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010変形性股関節症159162ENKazuoFujiwaraHirosukeEndoYoshiakiMiyakeToshifumiOzakiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010潰瘍性大腸炎の治療151154ENJunKatoNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010岡山県難病相談・支援センター151154ENYousukeKondouNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010岡山皮膚難病支援ネットワーク147149ENKeijiIwatsukiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010山陽地区神経難病ネットワークの活動143145ENTohruMatsuuraNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010岡山県難病医療連絡協議会の活動139141ENKen-eiSadaNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010緒言135137ENKeijiIwatsukiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010保存的治療が可能であった左半結腸切除後上腸間膜動脈症候群の1例：本邦報告47例の検討129133ENRyousukeHamanoShinyaOtsukaManabuNishieTsunehisaNomuraNaoyukiTokunagaHideakiMiyasouKenjiTakahashiYousukeTsunemitsuKazuyaMiyoshiMasaruInagakiKazuhideIwakawaMasahikoTakahashiHiromiIwagakiA 58-year-old man was diagnosed as having descending colon cancer and underwent a left colectomy with D3 node dissection and end-to-end anastomosis reconstruction. The accessory middle colic artery was secured as a feeding artery, and the middle colic artery was preserved. Diet was started on postoperative day 5 (POD5), and nausea and vomiting appeared on POD10. An upper gastrointestinal series revealed to-and-fro peristalsis in the third portion of the duodenum and dilatation of the proximal duodenum. Abdominal CT showed that the second portion of the duodenum was markedly dilated and the third portion was compressed by the superior mesenteric artery (SMA). As a result, he was diagnosed with post-operative superior mesenteric artery syndrome (SMAS) and treated with conservative therapy. The symptoms improved with a nasogastric tube, and he started to eat after POD26, followed by a successful outcome.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010白線ヘルニアの1例：本邦手術症例85例の検討125127ENHideakiMiyasoManabuNishieHiromiIwagakiHirooIshiiIsaoFujitaJunTomodaA 78-year-old woman visited our hospital after developing severe abdominal pain and upper abdominal swelling. An emergency operation was performed following a diagnosis of linea alba hernia with impaction of the falciform ligament of the liver as observed on CT findings. A defect of about 30 mm in diameter was observed in the linea alba, and preperitoneal adipose tissue and the falciform ligament of the liver prolapsed from the location of the defect and were impacted. We resolved the impaction of the falciform ligament of the liver by dissecting it, and we resected the preperitoneal adipose tissue. Simple closure was performed to correct the hernia orifice because the surrounding tissue was relatively rigid and the tension was mild. The patient's condition improved, and she was discharged on the 5th postoperative day.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010便中メチル化DNA検出による消化器がんスクリーニング：消化器がんを非侵襲的にスクリーニングすることは可能か？107112ENTakeshiNagasakaNoriakiTanakaDong-ShengSunYoshioNaomotoNagahideMastubaraTakahitoYagiToshiyoshiFujiwaraNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010精神腫瘍学概論119124ENYosukeUchitomiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010ダイナミン2による微小管の動態制御とCharcot-Marie-Tooth病113117ENKenjiTanabeKohjiTakeiNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010経皮的冠動脈形成術直前のニコランジル経静脈的投与による冠動脈slow flowの抑制効果101106ENYusukeKawaiKenichiHisamatsuHiromiMatsubaraYoshihisaFujimotoKatsumasaMiyajiMitsuruMunemasaKengo FKusanoTohruOheNo potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812222010TGF-β-Smad3経路と転写因子Sox9による軟骨細胞分化調節9599ENTakayukiFurumatsuToshifumiOzakiHiroshiAsaharaNo potential conflict of interest relevant to this article was reported.