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Volume 44, Issue 11
Displaying 1-11 of 11 articles from this issue
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Wataru YASUI, Yasuhiko KITADAI, Hirofumi NAKAYAMA2002 Volume 44 Issue 11 Pages 1923-1929
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSInformation of grade of malignancy in biopsy specimens is important because endoscopic mucosal resection against gastrointestinal tumors becomes routine in clinical practice. Biologi cal markers include a variety of cell cycle regulator, growth factors, angiogenic factors, cytokines and their receptors. Hypoacetylation status of histones also serves as a marker of high grade malignancy through altered gene expression. By analyzing known genetic and epigenetic abnormalities of cancer-related genes. the system of molecular-pathological diagnosis has been giving various useful information of grade of malignancy and tumor multiplicity . The genome science including analysis of single nucleotide polymorphism and serial analysis of gene expression will uncover precise mechanism of gastrointestinal carcinogenesis. New strategy of molecular diagnosis will identify characteristics of individual cancers and persons, which directly connects with personalized medicine.View full abstractDownload PDF (703K) -
Yukimitsu KAWAURA, Yasuhiko TATSUZAWA, Takurou TERADA, Yoshitaka ISHID ...2002 Volume 44 Issue 11 Pages 1930-1936
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 64-year-old man with epigastralgia visited to our hospital. Esophagoscopy revealed the presence of two lesions. One was a slightly elevated lesion located at the posterior wall of the middle third of thoracic esophagus 32cm from the incisor tooth with an irregular surface, and the other was a slightly elevated lesion located at the anterior wall with a flat surface. These lesions were stained yellow by iodine. The lesion of the posterior wall was treated three times by endoscopic mucosal resection (EMR). We did not perform EMR for the lesion of the anterior wall, because of the diagnosis of dysplasia. Again, a diagnosis of squamous cell carcinoma was made by biopsy specimens during endoscopic observation. We decided to perform surgery. Microscopic findings showed well differentiated squamous cell carcinoma. Two lesions of 28×18 mm and 12×10 mm in size were found in the middle thoracic esophagus, both of which had invaded only to the intraepitherial layer. Another lesion of 15×6 mm in size in the lower thoracic esophagus had invaded to the intra-proper mucosal layer. Multiple mild to moderate dysplasia 2-5 mm in size were recognized. In the reports, triple elevated superficial esophageal cancer is rare.View full abstractDownload PDF (1287K) -
Takayuki NAGAI, Hitoshi OOKAWARA, Shouichiro MATSUI, Akihiro UCHIDA, H ...2002 Volume 44 Issue 11 Pages 1937-1942
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe successfully performed endoscopic mucosal resection using EEMR-tube method (endoscopic esophageal mucosal resection-tube method). A 64-year-old woman with chest discomfort was admitted. A barium meal and endoscopic study revealed a tumor arising from the middle thoracic esophagus, with 4 cm of a longitudial diameter. The densitometric values of computed tomography were consintent with adipose type (-104H.U.). Endoscopic ultrasonography revealed a hyperechoic tumor in the submucosal layer. The histological diagnosis was benign lipoma. 39 cases of esophageal lipoma were reported in Japan. 11 cases of those were successfully resected by endoscopic technique. This was the second report on esophageal lipoma treated by EEMR-tube method.View full abstractDownload PDF (808K) -
Yuko KAWASAKI, Katsunori MASUDA2002 Volume 44 Issue 11 Pages 1943-1948
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 66-year-old female was admitted to our hospital for starting hemodialysis due to diabetic nephropaty. Esophagoscopy showed multiple round or elliptical punched-out ulcers in the midesophagus. Biopsy specimen taken from the mid-esophageal lesion showed multinucleated giant cell with ground glass appearance. Immunohistochemical examination showed positive for anti-HSV type 2. She was treated under symptomatic therapy and, two weeks later, herpes esophagitis improved spontaneously on endopscopy and histology.View full abstractDownload PDF (8350K) -
Yoshinori KIKUCHI, Yoshimi HAGISAWA, Keiji TAKAHASHI, Kazuo HIKE, Tomi ...2002 Volume 44 Issue 11 Pages 1949-1954
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 26-year-old man complaining of melena and lumbago was admitted to our hospital. Colonoscopic examination and barium enema revealed uneven mucosa with erosion and stenosis in the sigmoid colon. Computed tomography showed thickning of the wall of the sigmoid colon and lymph node enlargement in the area surrounding abdominal aorta. Poorly differentiated diffuse adenocarcinoma was diagnosed from the biopsy sample. We diagnosed disseminated intravascular coagulation (DIC) due to carcinomatosis of the bone marrow based on bone scintigraphy and blood laboratory data. A bone marrow puncture test revealed malignant cells identical to the colonic biopsy sample. He was treated with CPT-11+CDDP and MTX+5-FU sequentially, which was not effective, and died on the 84th day after admission. In this paper, we reported very rare case of young diffusely infiltrative colon cancer with carcinomatosis of bone marrow.View full abstractDownload PDF (8787K) -
Kazuhisa HIRAYAMA, Hiroyuki KIMATA, Toshio NAKAMURA, Atsuko FUKAZAWA, ...2002 Volume 44 Issue 11 Pages 1955-1959
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 65-year-old woman had undergone low anterior resection for rectal carcinoma . She had fresh bleeding from the anus 2 hours after the operation . Immediately an emergency endoscopic examination was done. The endoscopy revealed arterial bleeding on the suture line between the rectum and the colonic J pouch, and we had endoscopically hemostasis with the clipping method. Postoperative hemorrhage from anastomosis after low anterior resection that requires hemostasis is rare and there are few reports for the treatments of this complication . Since a large hemorrhage from anastomosis can cause a severe condition, endoscopic treatment for hemorrhage from anastomosis must be done even immediately after operation . The clipping method is good application and is considered a minimal invasive treatment for colonic tissue .View full abstractDownload PDF (7156K) -
Tsuyoshi CHIKU, Wataru SANO, Kazuyasu SHINNMURA, Tsuguhiko TASHIRO2002 Volume 44 Issue 11 Pages 1960-1964
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe performed endoscopic incision and dilatation with papillotome in 3 cases(two from our institution, and one from the other.)for stenotic colorectal anastomosis that occurred after anal sphincter preseveing operation with Double Stapling Technique(DST)for rectal cancer. All 3 cases received low anterior resection(LAR). Two cases were not eventful on pre and post operative course. In l case minor anastomosis leakage had occured. In all cases severe stenosis was noted and worsen their QOL. Making sure that there was no recurrence around the anastomosis, we treated these stenosis with endoscopic procedure g months after operation in the lst case, 9months in the 2nd case and 22 months in the 3rd case respectively. Radial incision with papillotome and manual dilatation with balloon dilator was performed. After the procedure, occasional finger bouginage was performed. Their clinical course was fair, and there are no re-stenosis. No complication such as bleeding or perforation had occurred. Their defecation was about 20r 3 times per day. It was concluded that endoscopic incision and dilatation with papillotome had been very useful and safe method for the treatment of stenotic colorectal anastomosis and had improved their QOL.View full abstractDownload PDF (9366K) -
Yuji INOUE, Toru TEZUKA, Takao NISHIKAWA, Itaru Ooi, Ken TAKASAKI2002 Volume 44 Issue 11 Pages 1965-1971
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS[Aim]This study was aimed at clarifying the appropriateness of planned endoscopic piecemeal mucosal resection for mucosal colorectal cancers. [Method] Forty one patients with mucosal colorectal cancer over 30mm in size undergoing planned endoscopic piecemeal mucosal resection at our institute between 1995 and 2000 were selected. In a retrospective study the usefulness of this treatment was analyzed. [Result] The average maximum diameter of the tumor was 42.2mm. The tumors were located in the rectum in 24 patients, the sigmoid colon in 14, the descending colon in 2, the transverse colon in 2, the ascending colon in 7 and the cecum in 3. Villous tumors were seen in 26, nodule-aggregating lesions in 9, mixed type in 3, Ip in 2 and lla in 1. Of 41 patients, resection was performed by one session in 36 and by multiple sessions in 5. As post-operative complication, bleeding were noted in 4 patients. Surgical resection was performed in 2 patients. Of 39 patients with complete endoscopic resection, residual tumors were seen in 9 patients and the recurrent tumor in 1 . All residual and recurrent tumors were resected by endoscopy. [Conclusion] The judgment of complete endoscopic resection is not always accurate . Unless recurrence is seen, the possibility of curative resection seems high. Furthermore residual and recurrent tumors can be resected again by endoscopy. Planned endoscopic piecemeal mucosal resection is thought be useful and should to be adopted for mucosal colorectal cancers aggressively.View full abstractDownload PDF (12880K) -
Taku KOBAYASHI, Shozo OKAMURA, Shinji OHASHI, Fumihiro URANO, Shinichi ...2002 Volume 44 Issue 11 Pages 1972-1976
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS‹Background› There have been occasional reports regarding the long-term prognosis of ulcerative colitis (UC) from Japan, but most of them were from specialist centers such as university hospitals, and the course and prognosis are changing because of new therapeutic options. ‹Materials & Methods› We investigated the course and long-term prognosis of 246 patients with UC who had visited Toyohashi Municipal Hospital. ‹Results› Surgical therapy was required in 23 of 246 patients (9.3%), colorectal or appendiceal carcinomas were found in 8 patients (3.3%). Eight patients (3.3%) died. Four patients died related to UC all within 4 years, and the 4 unrelated deaths occurred more than 7 years after the onset of colitis . We also investigated the prognosis especially in patients having UC for more than 10 years. Overtime, asymptomatic patients in complete remission increased up to 71.7% whereas patients having regular visits decreased. The onset of disease at younger age and proximal extension of the disease tended to be seen in symptomatic patients. ‹Conclusions› The activity of UC tends to decrease overtime, and most of life-threatening events occurred within the first few years, so the initial management seems to be important.View full abstractDownload PDF (6202K) -
[in Japanese]2002 Volume 44 Issue 11 Pages 1982-1989
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (970K) -
[in Japanese]2002 Volume 44 Issue 11 Pages 1990-1996
Published: November 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (841K)
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