センダイシ オヨビ ナトリシ デ シハンサレル トリ ヒキニク カラノ サルモネラ ノ ケンシュツ ホウコク

本研究では、宮城県で調査報告の少ない鳥ひき肉におけるサルモネラの汚染状況を調査した。その結果、市販される鶏ひき肉55.2％にサルモネラの汚染が確認された。この汚染レベルは、全国レベルに匹敵し、鶏の育成場所や鳥肉処理場、ミンチ加工処理、包装などが違えども、同程度の汚染がみられた。またムネ肉とモモ肉では、汚染には差が認められなかった。販売店舗としては調査した11店舗中10店舗の鳥ひき肉でサルモネラ汚染は認められたが、直接培養で検出されないなど、その汚染菌数は少ない。さらに冷蔵や加熱などの食品に認められる損傷菌に関しても、今回分離したサルモネラの37.5％が損傷菌である可能性がある。ここ宮城県仙台市および名取市で市販される鳥ひき肉からもサルモネラ菌の汚染が示されたことから、鳥ひき肉の調理や取り扱いにも十分注意することを強調したい

Mirizzi Syndrome with Cholecystobiliary Fistula: Observation of Development from Asymptomatic Cholecystolithiasis to Surgery

Despite a considerable number of reports of Mirizzi syndrome, none have described the process of its development from simple cholecystolithiasis. We report an extremely rare case of Mirizzi syndrome in which it was possible to observe the process of development of cholecystobiliary fistula from asymptomatic cholecystolithiasis until unavoidable surgical intervention 4 years later. A 68-year-old woman presented at our hospital with right upper quadrant pain. She had been diagnosed as having asymptomatic cholecystolithiasis 4 years previously. Diagnostic abdominal computed tomography (CT) had revealed a 1.9 cm radiopaque stone, and thereafter, the patient had been monitored by imaging alone. CT conducted 6 months before the present admission revealed that the gallbladder stone was compressing the common hepatic duct, although the patient remained asymptomatic. On admission, abdominal CT showed that the gallbladder stone was obstructing the common bile duct with dilatation of the intrahepatic duct. Endoscopic retrograde cholangiopancreatography revealed a round filling defect at the confluence of the common bile duct and the image of the cystic duct; therefore, the patient was categorized as having Mirizzi syndrome type III, according to the Csendes classification. Intraoperative findings revealed a cholecystobiliary fistula involving up to two-thirds of the circumference of the common bile duct

Safe Skin Management during Open Hepatectomy in a Patient with Recessive Dystrophic Congenital Epidermolysis Bullosa

Congenital epidermolysis bullosa is a rare, genetic condition in which even slight stimulation can cause blistering of the skin or mucosa. While previous reports of treatments requiring general anesthesia in these patients were focused on anesthesia-related procedures, such as endotracheal intubation, no report has described specific management required for these patients during surgery, such as preparation of the surgical site, fixation of infusion lines and other tubes, and adjustment of the operation table. This is probably the first report to address these issues. This report presents a case of recessive dystrophic congenital epidermolysis bullosa in which open hepatectomy was safely performed

Laparoscopic Resection of an Intra-Abdominal Esophageal Duplication Cyst: A Case Report and Literature Review

Duplication of the alimentary tract is a rare congenital malformation that occurs most often in the abdominal region, whereas esophageal duplication cyst develops typically in the thoracic region but occasionally in the neck and abdominal regions. Esophageal duplication cyst is usually diagnosed in early childhood because of symptoms related to bleeding, infection, and displacement of tissue surrounding the lesion. We recently encountered a rare adult case of esophageal duplication cyst in the abdominal esophagus. A 50-year-old man underwent gastroscopy, endoscopic ultrasonography, computed tomography, and magnetic resonance imaging to investigate epigastric pain and dysphagia that started 3 months earlier. Imaging findings suggested esophageal duplication cyst, and the patient underwent laparoscopic resection followed by intraoperative esophagoscopy to reconstruct the esophagus safely and effectively. Histopathological examination of the resected specimen revealed two layers of smooth muscle in the cystic wall, confirming the diagnosis of esophageal duplication cyst