Search

Crohn病（以下CD）に併発し穿孔性腹膜炎で発症した回腸癌の1例を報告する．症例は50歳代男性．11年前より小腸型CDと診断されていた．腹痛・発熱あり受診，腹腔内膿瘍と診断された．保存的治療にて軽快していたが約2カ月後腹痛・発熱が再燃し，小腸穿孔・汎発性腹膜炎と診断し開腹手術を施行した．膿性腹水および回腸の穿孔を認めたが明らかな腫瘤性病変は認めず，穿孔部および狭窄部を切除した．切除標本の精査にて，穿孔部の回腸に漿膜下に達する中分化管状腺癌を認めた．補助化学療法につき患者と相談し，術後は経過観察としたところ，再発のため術後21カ月目に死亡した．CDに併発した小腸癌は本邦では20例あまりの報告しかないが，CD患者の増加に伴って今後増加する可能性がある．CDの癌化リスクの疫学的評価，また有効な早期診断法の確立，また小腸癌の併発の可能性を念頭に置いたCDの経過観察・急性腹症の加療が必要と考えられる．

Human can quickly recognize the state of object surface. This sensation is called “Sense of Material”. When simulating materials with CG, the method of complex physical model is mainstream. However, this method causes large production time and cost so we propose simple material models based on human visual characteristics called “Tri-Contrast Perception Model” and “Binocular Parallax Model”. The results of discriminant analysis to some material samples, we found that binocular parallax is important affect for sense of material.

Click-evoked otoacoustic emissions were recorded from 28 ears of 20 patients with Meniere's disease. Evoked otoacoustic emissions (EOAEs) were present in 27 ears, although ears with hearing loss exceeding 40 dB HL were included. EOAEs recorded were examined by 100 Hz narrow-band EOAE analysis. This analysis permits easy detection of weak echoes in patients with severe hearing loss and aids in the analysis of characteristics of EOAEs which are composed mainly of fast and slow components. In general, the duration of EOAEs tended to be shorter in the ears of patients with Meniere's disease. There-fore, slow component with longer latency were diminished in amplitude even in patients with slight deafness. In ears with advanced deafness, the slow component disappeared and only the fast component with shorter latency persisted ; ultimately the fast component also disappeared if the hearing was severely impaired. These results suggest the possibility of the clinical application of EOAEs in the diagnosis of Meniere's disease.