群性膵炎の発症原因の検索中に発見された小膵癌の検討

急性膵炎の回復後その発症原因の検索において発見された小膵癌の3例を報告し，膵炎の発症原因の一つとして膵癌を常に念頭におく必要があることを強調した。またスクリーニング検査および精査において小膵癌を診断する手順について考察を加えた。症例1は初回発作の回復後に，症例2および症例3は再発発作の回復後に急性膵炎の発症原因の検索を目的に紹介された。いずれの症例においても血清腫瘍マーカーは正常植を示し，腹部USおよびCTは腫瘍から尾側の膵管の拡張を示したが腫瘍そのものは描出はできなかった。症例1ではERCP像から膵体部癌を強く疑い，症例2と症例3ではERCP像と細胞診陽性所見から膵頭部癌と確診し，手術を行った。腫瘍の最大径は症例1では0.9cm，症例2では1.5cm，症例3では2.0cmであり，いずれも転移を認めず根治切除可能であった。

Although gait training equipment such as the bicycle ergometer and treadmill exists for patients whose walking ability is high, there is no appropriate gait training mehtod or training instrument for patients whose walking ability has become impaired, who often use a cane or walker, etc. in the course of daily life. In the case of gait training for persons whose walking ability involves impaired locomotion, there is always the danger of a fall. Consequently, a caregiver is required, and the effect of the training is cut by half because the patient's anxiety about falling is exacerbated. Slow stepping affords strengthening and balance training of the leg muscles for patients whose walking ability has become low, and walking ability is improved. However,whether such training appropriately carries out stepping and the degree of the effect of such training has not been evaluated. Therefore, we have developed a stepping measturement device that monitors stepping for evaluation and training of walking ability. This system consists of two mat switches for stepping, a measuring circuit for stepping detection, and a book-sized personal computer with a PC card-type AD converter. This system can detect a left or right single stance phase and a double stance phase relative to the ON, OFF condition of the mat switch. After measurement, the following items are analyzed and displayed : ・number of steps, ・average time of double stance phase, ・the average time of single stance phase, and so on. Finally, we measured the stepping of subjects whose walking ability is low, and showed the relationship between daily walking conditions and stepping conditions. The effectiveness of this system was considered in light of the results.