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1.

論文(リポジトリ)

論文(リポジトリ)
又賀, 泉
出版情報: 新潟医学会雑誌 — 新潟医学会雑誌.  112  pp.119-123,  1998-03.  新潟医学会
本文リンク: http://hdl.handle.net/10191/45757
概要: Current conception and problems of the reconstructive procedures for both soft and hard tissue defects following oral cancer ablation have been introduced in this session. Total number of 137 flaps in 112 patients, 86 males and 26 females, reconstructed by major flaps such as musculocutaneous and osteocutaneous flap following radical resection with neck dissection and bony resection for oral cancer ablation in the Second Department of Oral and Maxillofacial Surgery, School of Dentistry at Niigata, The Nippon Dental University Hospital during ten years, from 1977 to 1996, have been retrospectively discussed. In recent, revascularized cutaneous flaps such as forearm, rectus abdominal flap and revascularized osteocutaneous flaps such as iliac, scapular and fibular flaps have applied more than pedicled cutaneous or musculocutaneous flaps such as forehead, deltopectoral, pectoral major musculocutaneous and latissimus dorsi flap because of easy reform for both defects of soft and bony defects by one stage, flexibility of designing and also no bone resorption is detected under the long term observation. After reconstruction, dental implant has been employed in the grafted bone and residual maxillo-mandibular bone for the masticatory and phonetic rehabilitation. Functional reconstruction is a big challenge for the quality of life of oral cancer patients. 続きを見る
2.

論文(リポジトリ)

論文(リポジトリ)
鈴木, 誠 ; 朔, 敬
出版情報: 新潟歯学会雑誌 — 新潟歯学会雑誌.  27  pp.9-14,  1997-07.  新潟歯学会
本文リンク: http://hdl.handle.net/10191/23000
概要: A series of 863 cases of cytologic examinations of the oral and maxillofacial regions, which had been performed during 6 years from 1990 through 1995, were reviewed, and efficacy of this method was assessed. Cytologic examination was applied mainly to the patients who were clinically suspected of malignancy at the initial stage of diagnosis, or those who wereb under course of anti-tumor therapy or post-therapeutic observation. The sensitivity for detecting malignancy was 74.8% and the specificity to diagnose non-malignant change was 79.8%. Overall accuracy was 63.6%. False negative rate was 34.8% and false positive rate was 13.8%. False diagnoses were mostly attributed to inadequate sampling. Careful attentions should be payed to sampling in order to eliminate false negativity. In the Papanicolaou's class III group, varieties of lesions were identified histologically. Class III should be applied only to the true borderline cytologic morphology. When the cytologic features are suggestive of a specific histologic criterion, the use of the histologic diagnosis is more recommendable than that of the Papanicolaou's classification.<br />新潟大学歯学部附属病院で1990年から1995年までの6年間に行われた細胞診検査863件の結果を解析し、細胞診の有用性と検査上の問題点を検討した。細胞診検査の対象となったのは主として臨床的に腫瘍が疑われる愚者で、その初診段階の診断や、治療経過中および予後の診査のために細胞診が行われた。細胞診と組織診が併用された305例について、良悪性の判定のための鋭敏性は74.8%、特異性は79.8%であり、全体の正診率は63.6%であった。偽陰性率は34.8%、偽陽性率は13.8%であり、これらを生じる理由として不適切な検体採取が注目された。したがって,検体採取から標本固定までの段階の処理を注意深く行うことにより、とくに偽陰性の頻度は減少させることができると考えられた。パパニコロウ分類クラスⅢと判定された症例には組織学的には各種の病変が含まれていた。しかし、クラスⅢは本来、真の意味の良悪性境界病変と考えられる細胞変化に限って用いられるべきものであり、それ以外の要因により判定困難な場合はクラス判定は避けたほうがよいと考えられた。したがって、細胞診の所見から特定の組織学的診断名が確定される場合には組織学的診断名を用いて表現することを提案した。 続きを見る