Sapporo Medical University Hospital Research Articles

塩酸服用による重症腐蝕性上部消化管炎の１救命例

A 28-year-old man attempted suicide by drinking a glass of dilute solution of caustic hydrochloric acid and was admitted to the Sapporo Medical University Hospital 3 hours later. Laboratory examination on admission showed metabolic acidosis, BE -8.9mEq/l. Endoscopic examination showed corrosive changes indicating injury to the deep layer of the upper gastrointestinal tract. The patient underwent surgery for severe caustic ingestion injury of the esophagus, stomach and duodenum to prevent perforative complications. After 84 days, esophageal reconstruction using the right colon with the terminal ileum was conducted, with excellent results were obtained. He was transferred to another hospital without further complication. Diagnosis and surgical treatment of caustic ingestion injuries remain controversial. After severe caustic injuries, patient survival is closely related to the delay between ingestion and surgical treatment. Our experience indicated that the decision for early operative intervention played a basic role in preventing of perforative complications.

Clinical study of hypopharyngeal carcinoma

A clinical study was performed of 83 patients with hypopharyngeal cancer treated in the Sapporo Medical University Hospital from 1982 to 1995. Five-year cumulative survival rate was 34.9% in the whole group and 37.2% in the radical surgical and/or radiation treatment group. In the radiation treatment group, the patients with T1, T2, N0 or N1 stage disease, especially those whose original disease responded almost completely to 40Gy irradiation, showed high tumor control rates following full-dose irradiation with or without radical neck dissection. In the radical surgery group, the patients with T4 or N2 stage disease showed better prognosis than those in the radiation group. However, among the patients with N3 lymph node metastases, there were no long-term survivors in either the radiation or the surgery groups.

当科における喉頭癌症例10年間の統計

One hundred fifty-nine cases of laryngeal cancer that were diagnosed and treated between 1983and 1992 at the Department of Otolaryngology, Sapporo Medical University Hospital were evaluated. There were 101 glottic (66.0%),53 supraglottic (33.3%) and 5 subglottic (3.1%) tumors.The overall five-year survival rate was 74.2%, while the ten-year survival rate was 62.7%. Regarding the primary site of the tumor, the glottic type was more curable than the supraglottic type and its five-year survival rate was 82.8%, while that of the supraglottic type was only 63.8%. There was no significant difference in the five-year survival rate of laryngeal cancer patients with and without lymph node metastasis.

Platelet GTP-binding protein in long-term abstinent alcoholics with an alcoholic first-degree relative

alcoholic patients had a family history of alcohol dependence. Ten subjects had an alcoholic first-degree relative (FLIP group; subjects had alcoholic fathers and/or siblings) and the other 10 had no first-degree or second-degree alcoholic relative (FHN group). The duration of alcohol use in the FHP and FHN group was 36.3 -+ t.33 and 34.9 +2.29 yea-s, respectively. Control subjects were agematched and gender*matched social drinkers drawn primarily from the faculty and staff of the Sapporo Medical University Hospital. The level of social drinking was determined by the Kurihama Alcoholism Screening Test (KAST), whereby a score of 2 or greater indicates a problem drinker. In addition to the KAST, both teetotalers and problem drinkers were excluded. The study procedures were fully explained and informed consent was obtained.