著者
清水 正嗣 水城 春美 福山 義邦 松本 有史 河村 哲夫 柳沢 繁孝
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.37, no.7, pp.1380-1384, 1991-07-20 (Released:2011-07-25)
参考文献数
10

A case with fresh gunshot wound penetrating from the left lateral neck to the mouth angle, which was caused by pistol shooting during a conflict between gangs, was reported and discussed by us.The patient, a 41-year-old male, was shot probably with a 38-caliber revolver from behind. Its entrance was on the left rear of the neck, and the exit hole at the left mouth angle. The route through the body: the bullet passed inside of the mandible, where it caused a crashing fracture of the body in the molar region while breaking the lower prosthesis. But, he was very lucky that the important blood vessels and nerve bundles were not injured, although the route was very close to them. He was transported to our Dept. that same day and operated on under general anesthesia for removing foreign bodies, uniting and fixing the jaw fracture, and also for reconstructing the mouth angle, while we sanitized the wound and sutured the soft tissues at each place. At last, a tracheotomy was performed, to prevent suffocation from postoperative swelling. The progress after the operation was good, and he was discharged three weeks later. After 3 years he is now healthy and in prison.
著者
清水 正嗣 小野 敬一郎
出版者
Japanese Society of Psychosomatic Dentistry
雑誌
日本歯科心身医学会雑誌 (ISSN:09136681)
巻号頁・発行日
vol.6, no.1, pp.41-47, 1991-06-25 (Released:2011-09-20)
参考文献数
12

The records of five oral cancer cases that committed suicide were studied psychosomatically. 4 were diagnosed as S. C. C. histologically and treated by oral surgeons and radiologists between 1959-1980 at the Uni. Hospital of Tokyo Medical and Dental University by Shimizu and others, and the remaining case was treated at a cancer center in Japan and the case history was examined for this study from the book written by the patient herself.The first case was a 50-year-old female with cancer of the upper left gum T4N1M0, which was treated with radiotherapy. Just one year later after the radiation, she committed suicide by jumping into a river, because of jaw pains due to tumor remains.The 2nd case was a 53-year-old male with cancer of the right cheek mucous membrane T3N2bM0, which was first treated with bleomycin, then with radiotherapy for 1. 5 years. After finishing radiotherapy successfully, the patient killed himself by hanging in the hospital due to the pain, although the tumor had clinically disappeared.The 3rd case was a 48-year-old female with cancer on the left side of the tongue T3NOMO. She was treated with interstitial radon seed radiation with success. After discharge from the hospital, she committed suicide by hanging herself at home afler complaining of pain and anxiety.The 4th case was a 55-year-old male with cancer on the right side of the tongue T3NlaMo. He was referred to the tumor conference, where the treating plan was decided to be radiotherapy. Before admission to the hospital, he killed himself by jumping into the Pacific Ocean from a ferryboat because he became pessimistic about the planned radiotherapy.The 5th case was a 59-year-old female novelist. She suffered from cancer on the right floor of the mouth and visited a cancer center, where a surgeon examined her and excised the tumor as a benign lesion. After that she was referred to the radiological department. The result of the radiotherapy was effective, but she thought her tumor would not disappear and hung herself at home due to severe mouth pain and great depression over the imagined future course of the tumor following the first failure of diagnosis and treatment.As causes of suicide by the patients with oral cancer, the side effect of pain during and after radio-therapy was pointed out at first, then the anxiety of the disease as cancer and distrust of the doctor played very important roles. For the future it should be stressed that we must not ignore these points as we examine and treat oral cancer patients.
著者
松田 登 小川 卓 井上 明 清水 正嗣
出版者
Japanese Society of Oral and Maxillofacial Surgeons
雑誌
日本口腔外科学会雑誌 (ISSN:00215163)
巻号頁・発行日
vol.26, no.5, pp.1263-1268, 1980-10-15 (Released:2011-07-25)
参考文献数
28

1) 26歳の男性でFallot四徴のある多血球血症患者の左側下顎骨内に生じた中心性血管腫の症例を経験した.2) 腫瘍を含む左側下顎骨半側切除を行い良好な経過を得ているが, 血管腫と多血球血症との関係は直接ないと思われた.
著者
清水 正嗣 松島 りん太郎 水城 春美 柳澤 繁孝
出版者
大分医科大学
雑誌
一般研究(B)
巻号頁・発行日
1988

臨床的には日常の診療において口腔前癌病変ならびに扁平上皮癌を有する患者の記録を行い,症例を重ねてきた.白板症における臨床所見と組織像との比較についてはdysplasiaの有無と発症部位との関連を調査したが,口腔に主として白板症の認められる頬粘膜,歯肉,舌の内では,舌が最もdysplasiaの発現し易い部位であることが本研究によって解明された.組織学的異型度と臨床視診型との関連については紅白斑型に異型を示す症例が目立って観察され,また,異型を示す症例ならびに多発性である症例に再発例が多い事が判明した。白板症が単発性であるか多発性であるかについては,その発症機序についても検索する必要があり,今後の課題の一つである。電気泳動法による分析に関しては等電点電気泳動法(IEF)とSDSポリアクリルアミド電気泳動法を用いてケラチンサブユニットの分析を行ってきたが,これらの分析では,泳動後のゲルを銀染色することにより感度の高い検出が行い得られ,小さな口腔内生検材料においても蛋白の検出が可能となった。しかしながら,口腔白板症ならびに扁平上皮癌組織よりClausenの方法他によって抽出したケラチン分画の分析ではケラチン以外にも数多くの蛋白が検出され,従来行われている二次元電気泳動のみによるケラチンサブユニットの検索法では正確なケラチンの同定が不可能と考えられ,ウエスタンブロッティングによるケラチンの同定が必要となった。現在,ケラチンに対するポリクロ-ナル抗体を用いてケラチンの同定が可能であるが,今後はモノクロ-ナル抗体による同定を行い,正確なサブユニットの構成を明らかにしたい。また,臨床的な予後に差異を生じさせる原因の解明についても,白板症ならびに扁平上皮癌は多様な形態,性質を有する事より,なお多くの生検材料の検索が必要であり,今後も継続していく方針である。