イガン サイハツゴ ノ テイアルブミン ケッショウ ト ナンジセイ オウト ニ ハロペリドール ガ ユウコウ デアッタ イチショウレイ

The patient was an 83-year-old woman who underwent laparoscopy-assisted distal gastrectomy for gastric cancer on February 25, 201X. S‐1 and UFT were performed, but metastatic liver cancer was seen on a CT scan on September 2. S‐1 was restarted on October 2６ but discontinued on January 18, 201X＋1 and best supportive care was adopted. She was hospitalized on April 15 for loss of appetite and anasarca. The patient had intractable vomiting and treatment resistance to metoclopramide and domperidone. ALB had decreased to 1．3 g/dl on April 22. A decrease in gastrointestinal motility from ascites retention was seen on a CT scan on April 25. Continuous subcutaneous infusion with haloperidol was started on April 25. The frequency of vomiting significantly decreased immediately afterward, and daily caloric intake significantly increased. Her ascites and anasarca were markedly improved on a CT scan on May 11. ALB had risen to 2．7 g/dlon June 14. Continuous subcutaneous infusion of haloperidol was effective for hypoalbuminemia and intractable vomiting after gastric cancer recurrence

ホウシャセン タンドク リョウホウ ガ ソウコウ シタ Merkel サイボウガン ノ 1レイ

A ９１-year-old man was diagnosed with Merkel cell carcinoma after removal of a mass about １ cm in diameter from the right upper eyelid on August ５, ２０１X. Curative surgery was recommended, but the patient declined. Lymph node metastases to the right lateral angle of the eye and in front of the right ear, and cancer pain in the stump recurrence manifested. Accordingly, irradiation of the right upper eyelid was started from October ３ at ２．５Gy/fraction, and the right lateral corneal lymph nodes were included from October １１, ending at ３５ Gy in １４ fractions. From November ２２，irradiation of the lymph node metastasisin front of the right ear was started, ending at ３２. ５ Gy in １３ fractions. During irradiation, cancer pain was alleviated with opioids. Stump recurrence and lymph node metastases were decreased in size, and Computed Tomography indiated complete response. Radiation monotherapy of Merkel cell carcinoma appears to offer a treatment that should be proactively applied when curative surgery proves difficult or not desired by the patient. Use of opioids during radiotherapy may improve quality of life and enhance the therapeutic effect

Internal Standard-Amplitude Modulated Multiplexed Flow Analysis

A new concept of flow analysis, internal standard-amplitude modulated multiplexed flow analysis, is proposed. A proof of concept was verified by applying it to the determination of ferrous ion (Fe2+) by 1,10-phenanthroline (o-Phen) spectrophotometry. The flow rates of sample solutions containing Methylene Blue (MB) as an internal standard substance were sinusoidally varied at different frequencies. The solutions were merged with a color reagent (o-Phen) solution, while the total flow rate was held constant. Downstream, analytical signals were monitored at the maximum absorption wavelengths of Fe2+-o-Phen complex and of MB (510 and 644 nm, respectively). The signals were respectively analyzed by fast Fourier transform. The concentrations of the analytes in respective samples were simultaneously determined from the amplitudes of the corresponding wave components. The precision, linearity of the calibration curve, limit of detection and robustness against deliberate fluctuation in flow rate were greatly improved by introducing the internal standard method. Good recoveries of around 100% were obtained for Fe2+ spiked into real water samples