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To increase delivery of L-dopa in its transdermal absorption, a new lipophilic derivative of L-dopa, L-dopa-butylester, was synthesized. An in-vitro study employing two-chamber diffusion cells, in which the excised rat abdominal skin was mounted, revealed that, in the presence of L-menthol and ethanol, L-dopa-butylester penetrated in its original form more effectively than L-dopa. L-Dopa-butylester sheets were made by immersing wiper sheets in methanol containing the compound, and then evaporating the methanol. An extraction study of the compound from the sheets revealed that its stability was maintained for at least 12 weeks. In an in-vivo cutaneous absorption study, an L-dopa-butylester sheet was attached to the shaved rat abdominal skin. A hydrogel containing L-menthol and ethanol was spread on vinyl tape, and this sheet was placed over it. In plasma, the L-dopa level rose linearly between 30 and 180 min after the cutaneous application; L-dopa-butylester was not detected. The L-dopa level was higher than that in which L-dopa was applied. These findings indicated that the lipophilic nature of L-dopa-butylester further increased its penetration through the skin, and that L-dopa-butylester that was taken up into the general circulation system was rapidly converted to L-dopa by hydrolysis in the body.

食道胃静脈瘤に対し, 内視鏡的硬化療法 (endoscopic injection sclerotherapy) を施行し, 経過観察中に食道癌を認めた症例につき術式上の工夫を加えたので報告する。症例は54歳の男性。1988年8月, 食道静脈嬉破裂に対しEISにて止血した後, 5か月にわたり頻回の追加治療を受けた。その後, 経過観察していたが, 1991年5月, 食道内祝鏡検査で下部食道 (Ei) に発赤を認め, 生検を行った結果, 扁平上皮癌 (深達度ep) の診断でレーザー治療を受けた。1992年1月, Elに再び癌を認めたため, 手術目的で入院となった。術前内視鏡では, 食道静脈嬉は改善されていたが, 胃静脈瘤を認めた。非開胸食道抜去, 胸壁前胃管再建に短胃静脈-外頭静脈吻合を加えた結果, 胃管鬱血, 静脈瘤の増悪に対処しえて良好な予後が得られた。

Splenic cyst are relatively rare and involve cystic lesions of a variety of origins. This paper describes a case of wandering splenic cyst with a high level serum CA19-9, together with review of the literature. A 24-year-old male was admitted to the hospital because of abdominal discomfort and abdominal mass. An abdominal tumor was palpated in the left hypochondria region which moved to the right hypochondria region on posture change. Abdominal ultrasonography, CT scan and MRI image showed the cystic mass lesion. The tumor was clearly diagnosed as wandering splenic cyst by scintigraphy and angiography. Serum CA19-9 showed high level of 13, 834U/ml. Splenectomy was performed. The resected spleen was measured 17×14×10cm in size, and 1.8kg in weight. The inner space was filled with yellow greasy fluid, of which CA19-9 level was as high as 5, 983, 118U/ml. Histologically the inside of the cyst was comprised of single- or double-layer squamous cell, and it was diagnosed as epidermoid cyst. This splenic cyst producing CA19-9 and wandering in the abdominal cavity is so rare.

後腹膜海綿状リンパ管腫の1例を経験した.症例は40歳男性で, 腹部圧迫感を主訴として来院し, 超音波検査にて蜂巣状構造を呈する巨大な腹部腫瘤を認めた.Computed tomographyでは左横隔膜下から膵後方を通り左腎下極に及ぶ内部構造均一な嚢胞状腫瘤としてとらえられ, 血管造影では血管成分の乏しい腫瘤と考えられた.超音波ガイド下穿刺にて乳康を吸引した.上記より後腹膜腫瘍 (リンパ管腫を強く疑う) の診断にて摘出術を施行した.大動脈周囲にて強固に癒着し腫瘍の辺縁は不明瞭となっていた.切除された腫瘤はスポンジ様の構造・弾性を呈し, 病理組織学的にリンパ管腫と診断された.後腹膜リンパ管腫の本邦報告例は約100例で, そのうち海綿状リンパ管腫は7例とまれな疾患であり, また浸潤性の発育・悪性化の問題点もあり文献的考察を加え報告した.