518 松 浦 梅 春 安 (図1)治 (図2)治 療 後 原 五 郎 佐 療 前 藤 実 血 液像,肝 機能 な ど異 常 な し. 治 療:昭 10mgを 和36年4月19日 よ りPredonine 局 所 注射 した とこ ろ劇的 効 果 を奏 し, 1週 間後 に来 院 せ る時 に は腫

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2 518 松 浦 梅 春 安 (図1)治 (図2)治 療 後 原 五 郎 佐 療 前 藤 実 血 液像,肝 機能 な ど異 常 な し. 治 療:昭 10mgを 和36年4月19日 よ りPredonine 局 所 注射 した とこ ろ劇的 効 果 を奏 し, 1週 間後 に来 院 せ る時 に は腫脹 ほ とん ど消失 し,疼 痛 な らびに圧 痛 は全 く認 め な かつ た. その 後 約2年 後 のFollow upで も再 発 を認 め ない. 症例4 沖 イ 昭 和36年5月 62才 女 中旬 頃 よ り誘 因 な く左 前 胸部 に軽 度 の腫 脹 と疼 痛 に 気 付 い た.圧 痛著 明で あ り,同 時 に右 肩 お よび右 上腕 に神 経痛 様疼 痛.お よ び軽 度 の しび れ感 を 訴 えた.癌 を恐 れ て直 ち に来 院 した. 初 診 時 全身 所見:体 格 中等度,栄 養 良好, そ の他 と くに著 変 を認 め な い. 局所 所 見:左 第2肋 軟骨 部 胸 骨 よ り約2横 指 外方 に拇 指 頭大 の腫 瘤 あ り,表 面 平滑 硬度 比 較的 硬,皮 膚 と癒着 な く下 部組 織 と固定 す. 圧痛 は著 明 で あ るが.発 赤,局 所 熱感,な ど な し.な お左 上 腕 神経 にそ い圧 痛 著 明で あ る. 臨 床検 査 成績:血 沈13/35mm,血 70mmHg胸 圧130/ 部X線 像 で は,多 少 の石灰 沈着 像 以外 異 常 な く,血 液,糞 便.尿 な ど異常 な し. 治療:昭 7.5mgを 和36年5月26目 よ り. Predonine 週1回 局 所 注 射 した.な お本 症 例

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4 1) Tietze, A.: Berl Klin. Wchnschr., 58: , ) Evans, G. and Eames, R. O.: Brit. M. J., 2: 352, ) Gedder, A. K.: Canad. M. A. J., 53: , ) Chantraine, H.: Deutsche med. Wchnscher., 77: , ) Gukelberger, M.. Schweiz. med. Wchnschr., 93: , ) Kayser, H. L.: A. J. M., 12: , ) Duben, W.: Deutsche med. Wchnschr., 77: , ) Celio, A. and Nigst, H,: Schweiz. med. Wchnschr., 86: , 1955, J. A. M. A., 160, 241, ) Mitchell., J. B.: Brit. K. J., 2: , ) Beck, W. C. and Berkheiser, S.: Surgery, , ) Motulsky, A. G. and Rohn. R.. J.: J. A. M. A., 162:

5 Tietze's Disease Results of new treatmeut with Steroids-hormon By Umeharu MATSUURA goro YASUHARA Minoru SATO Department of the 2nd Surgery Okayama University, (Director: Prof. Terutake Sunada) School of Medicine The first description of the Tietze's disease was given in 1921 by Tietze himself. His presentation was based on a studv of four personally observed patients, having a painful, non-suppurative swelling at the sternal end of the ribs. We don't have had the favorable treatment, including the surgical resection of ribs and deep x-ray therapy, however. Recently we had six cases with this syndrom in our department and gave the Hydrocor tisone 25 to 50mg or Predonine 5 to 10mg by local injection, which showed the excellent results. Also preferable were the local anaesthesia with 2% Xylocain prior to steroid-injection and regional cold formentation for one or two days after steroid-injection. We have to differentiate this syndrom from other conditions and believe that this treat ment is the first choice because of the simplicity of the procedure.

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