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Volume 41, Issue 5
Displaying 1-11 of 11 articles from this issue
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Naoko TSUJI, Shingo ISHIGURO, Noriko SUZUKI1999 Volume 41 Issue 5 Pages 1059-1065
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo investigate the risk factors of lymph nodse metastases from intramucosal gastric cancer, 740 consecutive cases of intramucosal gastric cancer were studied. Twenty three (3.1%) were node positive. A comparative study was made between node positive 23 cases and node negative 717 cases. 1) patients' age younger than sixty (p<0.05), 2) tumor diameter larger than 50mm (p<0.01), 3) macroscopically depressed lesions with ulcer or ulcer scar(p<0.01), and 4) signet ring cell carcinoma (p<0.01) were significantly predominant in node-positive cases. For further investigation, 46 control cases were matched to 23 node positive cases with respect to age, gender, tumor size, macroscopic type and main histological type. Histological types were redivided into three types, i. e. differentiated, mixed and undifferentiated. Depth of invasion eras devided into three levels Wltln the mucosa. Attachment lengh of cancer cells to the muscularis mucosae was measured in the sides of maximum diameter Immunohistochernical expressions of p53 protein, Ki67, CA19-9, 115D8 and DF3 were studied. Vascularities of cancer surrounding tissue were also measured using immunohistochemical staining of von Willebrand facter. 1) Histologically mixed type(p<0.01), 2) DisapPearance of the muscularis mucosae at the top of invasion (p<0.01), 3) Attachment length of cancer cells to the muscularis mucosae longer than 10mm (p<0.05), 4) p53 proteinpositive (p<0.01) and 5) vascularity of cancer surrounding tissue more than 30/mm2 (p<0.05), were significantly predominant in node positive cases.View full abstractDownload PDF (1005K) -
Seiji ABE, Manabu MUTO, Narikazu BOKU, Shinichi MIYAMOTO, Satoshi BABA ...1999 Volume 41 Issue 5 Pages 1066-1074
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe retrospectively studied the endoscopic findings in a series of 21 mucinous carcinomas of the stomach (Group A) and compared them with both 16 carcinomas partially accompanied with a component of rnucinous carcinoma (Group B) and 295 nonrnucinousgastric carcinomas (Group C). Two types of endoscopic findings were characteristically recognized in Group A: one was a "Fjord like margin" and the other was a" multinodular bubbly surface", The former appeared as a circurnferential extention of cancerous mucin compollent like a Fjord, and was seen in 52.4% (11/21) of the cases. The latter showed a thick white coating, multinodularity and bubbly surface, and was seen in 57.1% (12/21) of the cases. The "Fjord like margin" and "multinodular bubbly surface" signs were in 12.5% (2/16) in Group B and 0% (0/295) in Group C, in 12.5% (2/16) in Group B and 3.8% (8/295) in Group C, respectively. The positive rate of these endoscopic findings in Group A was significantly higher than that in Group B and C. Therefore, these results suggest that the "Fjord like margin" and "multinodular bubbly surface" endoscopic signs are characteristic features of mucinous carcinoma of the stomach. The comparison between these endoscopic findings and the pathological findings indicates that the former is formed by the process of the dcstruction of noncancerous gastric mucosa by the canccrous mucin componcnt, and the latter presents the exposed cancerous mucin component in the surface of the tumor.View full abstractDownload PDF (8669K) -
Yuji INOUE, Shigeru SUZUKI, Mamoru SUZUKI, Bunei IIZUKA, Toru NAKAMURA ...1999 Volume 41 Issue 5 Pages 1075-1082
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFifteen patients who showed superficial depressive type(type IIc)of early colorectalcancer were studied clinicopathologically. All patients were male with a mean age of 66years. The chief complain was most frequent with positive fecal occult blood in 6 patients, and the type IIc lesion was pointed out by colonoscopy in all patients. The tumor location, was most frequent in transverse colon in 5 patients, and 11 of 15 patients(70%)in the rightcolon(cecum, ascending colon and transverse colon). The averag:e size of the tumor was 11.1mm in diameter. On colonoscopy, the redness and the deforrnity of fold was seen in12patients(80%)and the conversing fold was in 2. Six patients had mucosal cancer andgpatients had submucosal invasive cancer, and 1 patient had submucosal invasive cancerwith lymph node metastasis. No recurrence was occurred in all patients after treatments, Thirteen of 15 patients(87%)had adenoma and 6 patients (40%) had the other colorectaladeneearcinema. In conelusien, careful abservation pn celeneseepy are needed to deteettype IIc lesion of which findings are reddening and deformities of the folds. The prognosisof type IIc of early colorectal cancer was favorable because the lymph nodes metastasiswere seen in l patient and because no recurrence was occu.rred in all patients.View full abstractDownload PDF (4115K) -
Takeo SEKIMATA, Hisasi USUKI, Setuo OKADA, Ken ISIMURA, Siniti YATIDA, ...1999 Volume 41 Issue 5 Pages 1083-1089
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 66-year-old Japanese man admitted for swallowing disturbance with a backache with barium swallow prominent lesion with a size of 20×40mm was observed at the middle part of the esophagus. Endoscopic examination revealed a pedunculate polypoid lesion coated with fur at the location of 34mm from the incisor. Without a confirmed diagnosis, endoscopic polypectomy was performed. The size of excised specimen was 34×20×15mm with a 4mm of peduncle. Histologically it was diagnosed as a capillary hemangioma. To our best knowledge, there have been 67 case reports (including our case) of the esophageal hemangioma in Japan. Twelve cases (18%) were endoscopically treated and seven cases of them had a peduncle. Three categories of endoscopic classification on esophageal hemangioma have been proposed according to their colors and forms. Fram the point of the indication for the endoscopic treatment, the pedunculate type of hemangioma should be added to the classification as a forth category.View full abstractDownload PDF (5021K) -
Yoshiyuki OGURA, Katsuhisa SATO, Yasutoshi SAITO, Yuichirou TOMITA, Ma ...1999 Volume 41 Issue 5 Pages 1090-1094
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-01d-man was introduced to our hospital because of an abnormal shadow in gastrointestinal series of the mass survey. Upper gastrointestinal endoscopy demonstrated a figure cf reflux esaphagitis, but biopsy specimen revealed well differentiated adenccar-cinoma. After various examinations, we diagnosed this lesion as esophageal adenocar-cinoma arisen in Barrett's esophagus, and this patient was performed partial gastrectomy. In the histological examination of the resected specimern, the depth of invasion of the lesion was limited in the mucosal layer and it was the Barrett's early esophageal adenocarcinoma. After the operation, the patient has been followed up in outpatient and free from cancer. Gastroesophageal reflux disease (GERD) was popular in Europe and North America, however, relatively rare in Japan. But, now, as our eating habits and life style become more Europeanized or Americanized, the patients of GERD are increasing and Barrett's esophagus (that is one of it's complication) is taken notice of as a precancerous disease. From now on, in case of refulx esophagitis, we should positively carry out biopsies withregular and long-term follow up in consideration of a possibility of Barretfs esophagus or carcinoma.View full abstractDownload PDF (3582K) -
Akihiko TACHIBANA, Naoto FUKUDA, Tatsuo YAMAKAWA, Takashi TSURUYA, Aki ...1999 Volume 41 Issue 5 Pages 1095-1100
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 89-year-old femal was admitted to our hospital because of upper abdominaldiscomfort. Endoscopic examination revealed multiple erosions at the lower esophagus.Despite extensive anti-ulcer drag therapy, markedly stenosis of the esophagus establishedduring a short period of time. Histological diagnosis of biopsied specimen was esophagitisand no malignant lesion was noted. After endoscopic balloon dilation for the stenosis ofthe esQphagu.s, metallic sten.t was placed at this portion. The final histological diagnosiswas Barrett esophagus, the biopsied specimen showed collmunar epithelium. The patientcontinued to be able to swallow normally on follow up. Treatment using metallic stent must be a good choice in the aged patients withesophageal stenosis due to Barrett esophagus.View full abstractDownload PDF (3575K) -
Manabu OHTA, Hiroyuki KONNO, Megumi BABA, Tatuo TANAKA, Toshio NAKAMUR ...1999 Volume 41 Issue 5 Pages 1101-1106
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDuplication of the stomach is a relatively rare congenital disease among the duplication of alimentary tract. A 39-years old Japanese rnan without any complaints wasadmitted to the Hamamatsu University Hospital because of the examination and treatment of the abdominal cyst demonstrated with ultrasonography. Pre-operative diagnosis was agastric cyst and laparotomy was performed. The lesion was covered with gastric serosaand could be separated from the gastric proper muscle. Histologically, smooth musclelayer and fundic gland was identified in the cystic wall, which was compatible with gastricduplication. Preoperative diagnosis of the gastric duplication is very difficult. The gastricduplication ought to be considered when a gastric subserosa cyst is detected.View full abstractDownload PDF (3921K) -
Satoshi TANI, Kensuke FURUKAWA, Masateru FUKUDA, Michiru MAEDA, Makoto ...1999 Volume 41 Issue 5 Pages 1107-1110
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA74-year-old man had repeatedly suffered from cerebral infarction resulting in theprogress of dysphagia. Therefore, a percutaneous endoscopic gastrostomy (PEG) wasperformed for the purpose of feeding, in which the gastrostomy tube was pulled down intothe stomach through the anterior abdominal wall using a Microvasive one Step Butten fit (18Fr). After 4 weeks of normal function, difficulties in the infusion of enteral feeding andtube leakage occured. Radiographic examination of the gastrostomy tube revealed theintaragastric bumper to be ernbedded in the abdominal wall. The tube could be removedpercutaneously sharpening the burnper using an obturator withou.t an endoscopic or surgical procedure. After removal of the tube, an 18 Fr Foley balloon catheter was replaced.This case suggests that the"burried bumper syndrome", which was reported to be seenusually in about 3 months after PEG, could occur as an earlier event.View full abstractDownload PDF (1686K) -
Motonobu KANDA, Kazuhiro MAEDA, Mitsuo OKADA, Yosifuku NAKAYAMA, Yosik ...1999 Volume 41 Issue 5 Pages 1111-1116
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 80 year-old-man was admitted to our hospital with cornplaints of constipation and abdominal pain. Since he had cerebral infarction ten years ago, he tended to be inbedridden state and constipation. He had anal pain and abdominal pain for two weeks before admission. With manual removal of stool by sacral block immediately performedafter admission, his symptom disappeared. Total colonoscopy and double-contrast bariumenema l week after admission revealed an irregular shaped ulceration with edema simulating cobblestoning and segmental stenosis in the sigmoid colon. There were no signifieantfindings in culture from the lesion and stool cultures. Biopsy taken from the lesion revealedexfoliated mucosa and disarrangement of muscularis mueosae and infiltration of neutro-phils. These clinical and macroscopic findings were consistent with typical findings cfsterccral ulcer and ischemic colitis. Thus, the patient was diagnosed as haying or diseaseof intermidiate type between stercoral ulcer and ischemic colitis. control of defecation. andbowel rest with TPN resulted in healing of ulcer in 7 weeks.View full abstractDownload PDF (5437K) -
Kazuya IWAMOTO, Hogara NISHISAKI, Hajime KANDA, Arata ISHII, Takao TAM ...1999 Volume 41 Issue 5 Pages 1117-1122
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 72-year-old man visited our clinic with a chief complaint of bloody stool. Colonoscopic examination revealed a lesion resembling a submucosal tumor, 5mm in diameter, inthe terarninal ileum. A histological diagnosis of carcinoid was made based on a biopsyspecimen taken from the lesion. Endoscopic ultrasonography showed the lesion invadingdeeply in the submucpsal layer. Having cpnsidered the depth and lpcation of the carcinid tuner, ileeceeal resectien was performed. Only 7 cases of carcineid turners in the terminalileum diagnosed before operation have been reported in Japan. Our case is the smallest oneof the 7 cases.View full abstractDownload PDF (3465K) -
Yukiko UENO, Shuichi AMAKI, Miki KANEKO, Sanae CHINO, Tamiko KANEKO, A ...1999 Volume 41 Issue 5 Pages 1123-1128
Published: May 20, 1999
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 54-year-old female without history of blood transfusion. Herbrother had died of cirrhosis and hepatocelluler carcinoma. While being treated forhypertension and diabetes, she was found in the course of a healthcheckup to havepericardial fluid retension and admitted to hospital. The initial examination demonstrated hepatic dysfunction and positivity for anti-HTLV-I antibody. According to the hematoanalysis blood examination on the presentadmition, WBC stood at 8000/μl, the hemoglobin at 12.6g/dl, and the platelet count at 14.5×104μl, with no abnomality in the hematological profile.The GOT level was estimatedat 68 IU/l and the GPT at 66 IU/l ; the γ-GTP increased to 133 IU/l; the IgG stood at 2500mg/dl. The patient was 640-dil positive for the antinucler antibody and positive for HTLV-I examined by means of Westernblot's method. Bone marrow was normal. HLA typingdetected the presence of DR4. The margin of the right hepatic lobule had become thick and obtuse by laparQscopicexamination. On the rough and irregular surface of the liver were:noted groove depression, coarse unducation, and reddish marking, which were in conformity with manifestations ofAu.toirnmune hepatitis. Attention has already been raised in the association of HTLV-I infection with autoim-mune disease, We considered that our patient would provide us with a significant into thepathogenesis and clinical progress of autoimrnune hepatitis.View full abstractDownload PDF (3572K)
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