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1.

論文(リポジトリ)

論文(リポジトリ)
高久, 秀哉 ; 福田, 喜一 ; 角南, 栄二 ; 石塚, 基成 ; 松澤, 岳晃 ; 黒崎, 功 ; 畠山, 勝義 ; 味岡, 洋一
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  122  pp.347-353,  2008-06.  新潟医学会
本文リンク: http://hdl.handle.net/10191/19523
概要: 症例は75歳男性.2003年12月初旬,水様性下痢を主訴とし当院受診.腸炎の診断にて入院,保存的治療を開始した.その後,腸閉塞となり,腹部CTにて小腸の腸重積と診断し,12月中旬手術を施行した.褐色調の腫瘍を先進部とした2か所の重積腸管を認 め小腸部分切除を行った.他に計9個の腫瘍が小腸に散在性に存在したため,更に2か所の小腸部分切除を施行した.他の腹腔内臓器の異常は認められなかった.病理組織学的検査で,悪性黒色腫(amelanotic type)と診断された.術後11病日のCT検査にて,多発性に肝転移,脾転移,脳転移,肺転移を認めた.原発部位の同定は困難であった.全身状態悪化のため,化学療法は施行し得ず,術後28病日に死亡された.腸重積にて発症し,術後急速な経過をとった小腸悪性黒色腫の1例を経験したので報告する.稀ではあるが,腸重積の原因として,小腸悪性黒色腫を鑑別にあげる必要がある. 続きを見る
2.

論文(リポジトリ)

論文(リポジトリ)
兼子, 泰行
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  105  pp.177-186,  1991-03.  新潟医学会
本文リンク: http://hdl.handle.net/10191/38651
概要: To investigate alterations in the basement membrane (BM) and of fibronectin receptor (FNR) in malignant melanoma (MM), t he tumor were studied immunohistochemically by double immunofluorescent staining using monoclonal antibodies to the core protein of heparan sulfate proteoglycan(HSPG), collagen type III(C-3)and chondroitin 6-sulfate (C6S) as well as antiserum to laminin, collagen type IV (C-4), fibronectin and fibronectin receptor. In MM in situ, C-4, laminin and HSPG were preserved as a continuous linear band on the dermo-epidermal junction (DEJ), while C6S is extensively lost from the DEJ and fibronectin is remarkably decreased in the papillary dermis compared with the normal skin. In invasive, MM, although the distribution pattern was varied case by case, the BM components were not decreased. The cases were divided into two groups by the distribution pattern; a great amount of each BM component were localized on the surface of tumor cells, or surrounded tumor nests, forming the large nests. In all but one cases examined, however, C6S was absent from the BM zone of the melanoma nests in the dermis. These data indicates that although C6S was absent, the other BM components were actively synthesized by tumor cells, and that the BM components were altered in phase of MM in situ. Intensity of FNR of melanoma cells were generally more fainter than those of infiltrating lymphocytes in the dermis, basal cells of the epidermis and endothelial cells of small vessels. There were no significant differences in their intensity of melanoma cells between each tumor progression phase. Therefore, the present study may reveal that these receptors do not relate to invasion or metastasis of the tumor. 続きを見る
3.

論文(リポジトリ)

論文(リポジトリ)
児玉, 省二 ; 吉谷, 徳夫 ; 遠間, 浩 ; 中村, 稔 ; 田中, 憲一
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  107  pp.394-398,  1993-05.  新潟医学会
本文リンク: http://hdl.handle.net/10191/37390
概要: We retrospectively analyzed clinicopathological review of 4 patients with primary malignant melanoma of the female genital tract. Of these patients, two had cervical lesion, one had vaginal lesion and one had vulvar lesion. The age of 4 patients were 33, 41, 82 and 84-year-old. One patients with cervical lesion treated with only chemotherapy because of advanced stage (stage IV disease with lung metastasis). Of the 3 patients treated by surgery and lymph nod dissection, 2 had nodes involved by tumor. In the histologic classification of melanoma, 3 patients had mucosal melanoma and one patient had acral lentiginous melanoma. All patients had advanced tumours and depth of invasion was greater than 8mm in 3 cases treated by surgery. Various chemotherapeutic regimens, PAV, DAV and PVB, were employed. Three patients died of disease within 15months after diagnosis. One patient treated with chemotherapy died of pneumonitis, with disease, at 4months. 続きを見る
4.

論文(リポジトリ)

論文(リポジトリ)
五十嵐, 文雄
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  107  pp.399-403,  1993-05.  新潟医学会
本文リンク: http://hdl.handle.net/10191/37392
概要: A clinical study was conducted on 16 patients with malignant melanoma who were registered between 1986 and 1990 by the registration committee for malignant head and neck tumors of Niigata prefecture. Ten tumors originated in the nasal cavity, 3 in the cervical skin, 2 in the paranasal sinus, and 1 in the lower gingival mucosa. The mean age of patients was 64.8years, and 10 were men and 6 were women. The inital symptom of tumors originating in the nasal cavity or paranasal sinus was epistaxis or nasal obstruction, whereas that of tumors originating in the cervical skin or the lower gingival mucosa was tumor formation. The mean duration from the appearance of the initial symptom to consultation was 5.0 months, that of tumors originating in the mucosa was 3.8 months, and that of tumors in the skin was 10.0 months. The mean duration was significantly shorter in mucosal tumors than in cutaneous ones. The most common local findings were black or black-brown tumor, black or black-brown pigmentation, or both. However, in 4 nasal and paranasal tumors, dark-red or grey-white tumor that resembled nasal polyp was recognized. Radical treatment was performed in 14 cases, and palliative treatment in 2. In radically treated cases, surgery was the main therapy, and chemotherapy or radiotherapy ware used adjuncts. Palliative treatment consisted of radiotherapy or injection of interferon. At this time, 6 patients are tumor free, 3 are alive with tumor, and 7 have died. As the major cause of death was distant metastasis, more effective general therapy is needed. 続きを見る
5.

論文(リポジトリ)

論文(リポジトリ)
加藤, 譲治
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  107  pp.403-411,  1993-05.  新潟医学会
本文リンク: http://hdl.handle.net/10191/37393
概要: The therapeutic methods were discussed in 7 patients of the primary malignant melanoma on the oral mucosa, who were treated at Dept. of Oral and Maxillofacial Surgery II, School of Dentistry at Niigata, The Nippon Dental University, for 13 years, from 1978 to 1991. Then the following conclusions were elucidated by our clinical analysis, including the connection with pigmentation. 1. Primary malignant melanoma on the oral mucosa tended to be detected lately by the existence of dental prosthetic appliances, such as full denture, bridge and etc., because it most likely occured on the maxillary gingiva and hard palate. Therefore the patients become aware of the symptoms lately and, when they visited to our department, the focus has already expanded and metastasized to the other parts frequently. 2. The prodromal symptoms of primary malignant melanoma on the oral mucosa were not even clear by now and it is needed to exercise pursuits on the patients with pigmentation of oral mucosa carefully. 3. Although a wide excision of the peimary focus in soite of the anatomical difficulties was worked out, metastatic diseases, mostly lungs, after 6 through 18 monthes were detected and all the patients were died within 2 years. It is necessary to establish more reliable methods for the prevention or control the postoperative metastasis in the future. 続きを見る
6.

論文(リポジトリ)

論文(リポジトリ)
小山, 真 ; 榎本, 一彦 ; 阿部, 僚一
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  107  pp.412-419,  1993-05.  新潟医学会
本文リンク: http://hdl.handle.net/10191/37398
概要: Four patients with advanced melanoma had been treated with the amino acid imbalance therapy using the Phenylalanine-Tyrosin deprived milk by the authors at the surgical unit of Sanjo Saiseikai Hospital and Niigata prefectural Yoshida Hospital within past 15 years. In three of four patients, the therapy showed the remarkable effects. The reduction of the ulcerating melanomas in patient 1 and 2 or the disappearance of the recurrent melanoma of the colon of patient 3 were observed within 1 to 4 weeks after the start of the therapy. In patient 4, who had too extensive dissemination of the melanoma, the therapy could not show the effect. As a result, patient 1. whose melanoma became resectable by the therapy and patient 3, whose recurrent melanoma of the colon was disappeared by the therapy could survive for a long time of 16 and 6 years respectively withont any sign of recurrence of melanoma. But, patient 2, who could not tolerate the therapy, and patient 4 died of melanona at 12 and 2 months after the therapy. Thus, the authors would like to stress the importance of further studies to confirm a possible validity of the Phenylalanine-Tyrosin deprived amino acid imbalance therapy for the treatment of patients with melanoma, because the therapy revealed the appreciable effects on the advanced melanomas of three of four patients to whom chemoimmunotherapy was uneffective by the authors' clinical experiences. 続きを見る
7.

論文(リポジトリ)

論文(リポジトリ)
勝海, 薫 ; 島田, 稚 ; 島垣, 和花 ; 和泉, 純子 ; 佐々木, 嘉広 ; 伊藤, 雅章
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  107  pp.419-424,  1993-05.  新潟医学会
本文リンク: http://hdl.handle.net/10191/37396
概要: Forty five cases of cutaneous malignant melanomas in Department of Dermatology, Niigata University School of Medicine du ring the period 1976~1990 were statistically studied. These cases consisted of 16 males and 29 females. The peak for age distribution was seen between 60 and 69 years old and the average age of the cases at first visit was 57.9 years. Acral lentiginous melanoma accounted for 51.1%, nodular melanoma 15.6%, superficial spreading melanoma 17.8%, lentigo maligna melanoma 4.4% of the total cases. Ten cases (22.2%), 6 cases (14.7%), 23 cases (51.1%) and 6 cases (14.7%) were in stage I, II, III and IV, respectively. The histological micrometastasis of lesional lymph nodes was recognized in 6 cases (23.1%) of the 26 cases who had received prophylacted lymph node dissection. The tumor thickness and level of all the 6 cases were over 1.5mm and level III, respectively. Seven out of the 26 cases who had received prophylacted lymph node dissection were dead. The tumor thickness and level of all the 7 cases were again over 1.5mm and level III, respectively. The five years survival of the stage I cases was 89%. Those of stage II, III and IV were 67%, 39%, and 0%, respectively. It is confirmed that the tumor thickness and level of the primary lesions correlates well with their prognosis. 続きを見る
8.

論文(リポジトリ)

論文(リポジトリ)
三嶋, 豊
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  107  pp.430-437,  1993-05.  新潟医学会
本文リンク: http://hdl.handle.net/10191/37401
概要: Progression of human melanomas occurs by focal and multi-step oncogenesis from normal pigment cells. Accentuated melanosome-genesis accompanies this process through precancerous stages to malignant melanoma along with possible genetic alterations, which should be more fully explored for better melanoma control. Refined criteria based on new molecular to clinical analyses of lesion behavior, need to be made for each step of melanoma progression. Melanoma progression is found to be associated with a variety of structural and biochemical changes in cell surface and in cytoplasmic molecular properties, e.g. membrane carbohydrate and antigen expression dynamics, pheomelanogenesis, oncogene including suppressor gene expression, chromosome abnormalities and A^X actin synthesis. Based on these basic and clinical findings, our scheme on melanoma oncogenesis (see Table 1. in the attached Japanese section of this paper) has been elucidated. 続きを見る
9.

論文(リポジトリ)

論文(リポジトリ)
藤川, 大基
出版情報: 新潟医学会雑誌.  133  pp.226-229,  2019-06.  新潟医学会
本文リンク: http://hdl.handle.net/10191/00051857
概要: 皮膚悪性黒色腫の治療の中心は手術療法と薬物療法である.遠隔転移がみられない場合は原発巣の拡大切除を行い,進行の程度によってはセンチネルリンパ節生検や所属リンパ節郭清術も併せて行う.最近,センチネルリンパ節生検とその後の郭清術に対する新たなエ ビデンスが確立されてきている.根治切除不能な進行期に対しては長年有効な薬物療法がなく,予後は非常に悪かった.近年,悪性黒色腫に対して免疫チェックポイント阻害薬や分子標的薬といった新薬の承認が続いており,進行期でも生存期間の延長や完全寛解までも望めるようになった.しかしながら,依然として治療に抵抗性の場合も多く,さらには免疫関連有害事象への対策など新たな課題もある. 続きを見る