A case of esophageal cancer with mesojejunal lymph node metastasis after total gastrectomy

A 56-year-old man was diagnosed with esophageal cancer by upper gastrointestinal endoscopy for examination of dysphagia. The patient had undergone total gastrectomy and jejunal interposition 4 years previously for a gastric cancer at the pT1N0M0 stage according to the UICC-TNM classification. Enhanced CT findings revealed a 3-cm-diameter mass located near the superior mesenteric artery. We conducted subtotal esophagectomy associated with partial jejunectomy including mesojejunectomy. The mass was histologically diagnosed to be mesojejunal lymph node metastasis from esophageal cancer. Mesojejunal lymph node metastasis from esophageal cancer developing after total gastrectomy has been reported in only three cases including ours. The present lymph node metastases may have occurred via the newly developed lymphatic drainage route through the esophagojejunostomy, and this metastatic lymph node can be considered the regional lymph node. Therefore, resection of the interposed jejunal limb with mesojejunectomy may be rational in surgery on esophageal cancer developing after total gastrectomy

チュウガクセイ ト ソノ オヤ セダイ ニ オケル ジンセイ ニ タイスル カチカン ト オヤコ カンケイ

A questionnaire survey was carried out among junior high school students (n=158) and their parents (n=158) to clarify the most important things in the value of life for each of them, and to know whether they have intimate parents-children relationships and how the relationships influence on the establishment of the value of life. 1. As compared to the male students, the female students showed in a higher response rate a tendency not to care much about whether or not they were being married and they have their own children at their adult ages, and the female students had a better communication with their parents. 2. As for the most important things in life at adult ages, the students responded to have a happy family and success of work, and the female students as well as the male students had thought of that having a job and spending a self-reliant life are important. lt was important for the parents generations that their children are being respected from others and have children when grown up. 3. For the students who had many conversations with the parents, it was thought to be important that their daily life with volunteer activities could bring them sense of well-being, and that at their earlier stages of life they become possible to spend self-reliant life. For the students who had few conversations with parents, it was important to have success in their work and to be promoted to higher ranks. 0n the other hand, for the parents who had many conversations with children, it was important to have their own children because to do that should bring them sense of well-being