Showing papers by "Yoshiyuki Iida published in 2006"

Primary adenoid squamous cell carcinoma of the oral cavity.

Abstract: Adenoid squamous cell carcinoma (ASCC) is an uncommon but well-recognized variant of squamous cell carcinoma that was first described by Lever in 1947. ASCC has been reported to originate in the sun-exposed skin of the head and neck and in other sites. An additional case of ASCC is reported here. The patient was a 64-year-old Japanese woman who requested examination of a reddish lesion on the left floor of the mouth. The biopsy material was diagnosed as squamous cell carcinoma. Clinical examination showed a well-circumscribed, 20 x 10 mm-sized lesion, which was categorized as cT2cN0cm 0. Tumor resection was therefore performed. Histologically, most parts of the lesion were conventional squamous cell carcinoma in situ, but the invasive part consisted of ASCC with gland-like or reticular appearance. The latter part was negative for mucin staining. Immunohistochemically, this lesion was positive for pancytokeratin, high-molecular-weight keratin, cytokeratin (CK) 7/8, CK19, E-cadherin and p53, but negative for vimentin, CK20, and S-100 protein. The Ki-67 labeling index was 50.3% in the ASCC part and 34.5% in the carcinoma in situ part. These findings and a review of the literature indicate that a gland-like feature of ASCC is associated with the loss of cell adhesion in the center of the cancer nests, and it can be confirmed simply by mucin staining to be neither an adenosquamous carcinoma nor ductal involvement of conventional squamous cell carcinoma.

The clinical pathway for free jejunum reconstruction in shizuoka cancer center hospital

Abstract: 一般に，手術侵襲が大きく合併症が多い治療にはクリニカルパスの導入は難しいと考えられている。当院では，下咽頭癌に対する咽喉食摘，遊離空再建手術においてパスを用いた周術期管理を試みている。2002年12月から2005年12月までにパスを適用して遊離空腸再建術を行った36症例について，アウトカムとバリアンスを検討した。バリアンスの評価とパスの適切な修正により前期17例と後期7例を比較すると，歩行開始までの日数は4日から2日に，食事開始までの日数は9日から7日に短縮し，経口摂取量も増加して，ADLの早期改善が可能となった。入院期間は変化しなかった。パス逸脱症例は41%から14%に減少して，パスによる周術期管理が順調に稼動されるようになった。電子カルテシステムと統合してパスを構築することにより，多職種が情報を共有でき，チーム医療をスムーズに展開することができた。