Cesium Implant for Tongue Carcinoma with a Thickness of 1.5 cm or More: Cases Successfully Treated with a Modified Manchester System

PURPOSE: Deciding on treatment carcinoma of the tongue when the tumor has a thickness of 1.5 cm or more is difficult. Surgery often requires wide resection and re-construction, leading to considerable functional impairment. A cesium implant is an attractive option, but according to the Manchester System, a two plane implant is needed. MATERIALS AND METHODS: According to the textbook, a tumor is sandwiched between the needles, which are implanted at the edge of the tumor. This may cause an unnecessarily high dose to the outer surface of the tongue, which sometimes leads to a persistent ulcer. To avoid this complication, we invented a modified implantation method, and applied the method to five consecutive patients. RESULTS: With a minimum follow-up of 2 years, all primary tumors in 5 consecutive patients have been controlled. No complications occurred in soft tissue of the tongue or in the mandible. CONCLUSION: Our modified Manchester System was feasible and effective for tumors that has a thickness of 1.5 cm or more.

The Influence of Vascular Wall on Wrapping Method in the Canine Aorta / 日本心臓血管外科学会雑誌

There is still considerable risk when performing anastomotic procedures in the aorta and artificial vessels. The wrapping method is occasionally used as an alternative to solve the problems of hemostasis and reinforcement of the anastomotic portion, however, few data are available on the results of long-term follow up after anastomosis in this area. To define the long-term results for the wrapping method, we evaluated changes in the vascular walls of set intervals. The purpose of this study was to analyze the influence of technical factors and to sutisfy the prerequisites for an ideal wrapping method. A total of 26 mongrel dogs of both sexes were used in this study. We examined changes of the aortic walls microscopically of set intervals after a wrapping method using woven Dacron materials for 4 weeks and 4 months. Another 2 groups (Mesh group and E-PTFE group) were also included in this study. The cause of thinning phenomena of the aortic walls appears to be compression of the anastomotic portion. Wrapping materials resulting in excessively small diameters may cause deleterious compressions of the anastomotic site. Wrapping methods with materials ensuring a larger diameter may play an important role after anastomotic operations for reinforcement and hemostasis.