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Volume 39, Issue 10
Displaying 1-17 of 17 articles from this issue
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Takashi YASUHARA, Kimiaki ONOUE, Hiroshi KONO, Tatsuo IWAMOTO, Akira S ...1985 Volume 39 Issue 10 Pages 842-846
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSRecently, a variety of hemostatic measures under endoscopy became popular. This time, we report a clinical study of a local injection of pure ethanol with satisfactory results.
The patients were consisted of 28 cases including 23 cases of gastric ulcer, 1 case of duodenal ulcer, 2 cases of Dieulafoy's ulcer and 1 case of hemangio-sarcoma. We injected pure ethanol for these patients 1-2 mm around the exposed vessel (EV) or bleeding point, 0.1-0.2 ml per one time for 3-8 times, and followed them endoscopically for 1-7 days.
There were five lesions of active bleeding and 23 of EV. Permanent hemostasis was obtained in 24 cases (86%), temporary hemostasis in 4 (14%) and no cases were ineffec-tive. Local injection of both pure ethanol and hypertonic saline-epinephrine solution (Bosmin method) was performed in 8 cases. Pure ethanol was effective in all 8 cases, although Bosmin method was effective only in 3 cases.
An emergency operation has been one of the first choices until recently in cases of acute upper gastrointestinal hemorrhage. We think, however, this method is one of the most useful hemostatic measures and should be the choice of acute management of these cases.View full abstractDownload PDF (603K) -
Atsuro FUTAMURA, Tomihisa FURUTA, Kimiyuki SUGIMOTO, Ren HORIBE, Toshi ...1985 Volume 39 Issue 10 Pages 847-854
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSEighteen operations were performed for 15 premature infants with low birth weight (less than 1, 500 grams) during the past 5 years from 1979. There were 7 male and 8 female patients. The average period of gestation was 27.5 weeks ranging from 25 to 35 weeks, and the average birth weight was 966 grams ranging from 725 to 1, 208 grams. In this series, there were 11 cases of ligation of ductus arteriosus for PDA (including 2 cases of bowel resections for necrotizing enterocolitis and intestinal volvulus), 2 bowel resections for necrotizing enterocolitis and each case of esophageal atresia and meconium plug syndrome (including one case of reoperation). Eight cases survived after the operation (survival rate was 53.3 per cent). There were many difficulties in the man-agement of pre- and postoperative periods due to prematurity, but it is suggested that the early diagnosis and the early operation can contribute to an increase in the operative survival rate even in those with severely premature infants.View full abstractDownload PDF (2321K) -
THE JOINT STUDY UNIT OF DIAGNOSIS AND TREATMENT OF1985 Volume 39 Issue 10 Pages 855-862
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSOne hundred and six cases of esophageal varices were divided into two groups, that is, 56 cases treated with endoscopic sclerotherapy (group A) and 50 operated cases (group B). A clinical comparison was made between these two groups. Seventy-eight 96 of group A and 83.9% of group B were accompanied with liver cirrhosis. Hepatitis virus of B type and non-A non-B type, and alcohol were the three major causes and they were equally seen. With respect to the clinical signs and symptoms, jaundice and meteorism were rare and ascites, SKD, enlarged dullness of spleen, hepatomegaly were relatively common in both group. The laboratory data demonstrated that significant improvement of gamma-GTP and triglyceride in group A and gamma-GTP, LAP, ZTT, cholesterol and total protein in group B was observed after the treatment. Endoscopic findings of esophagus was not different in both group, but more esophageal varices were detected up to the middle and the upper part of the esophagus in group A than in group B. Endoscopic sclerotherapy was done once in 45 cases, twice in 10 cases and three times in one case. Operated cases were consisted of 7 cases of prophylactic, 22 cases of protective and 20 cases of emergency op-eration. Prognosis of these groups was not significantly different between group A and group B, and furthermore, among the three groups of prophylact, protective and emer-gency operation.View full abstractDownload PDF (952K) -
Toru YASUTOMI, Koji MAKINO, Mihoji OKAMOTO, Hidenori YOSHIOKA, Nobuyuk ...1985 Volume 39 Issue 10 Pages 863-865
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSEsophago-cardioplasty using a gastro-patch was performed in a patient with esophageal achalasia. The esophagus was dilated in diameter of 10 cm before surgery (Sygmoid type, Grade III, according to GENERAL RULES FOR THE DESCRIPTION OF ESOPHA-GEAL ACHALASIA).
Impaired passage at esophago-cardiac junction which was present preoperatively im-proved remarkably and recovery of peristalsis was confirmed by postoperative esophageal fluoro- scopy.
Postoperative recovery was most marked in this case compared with other few cases treated by other surgical methods in our hospital.View full abstractDownload PDF (2193K) -
—A TRIAL OF A TOPICAL INJECTION OF PURE ETHANOL—Takashi YASUHARA, Hiroshi KONO, Shunsuke SASAKI, Fumio ARAKI, Hidenori ...1985 Volume 39 Issue 10 Pages 866-869
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA tumor metastatized to the stomach from a tumor of the other organ is relatively rare. We report a case of hemangiosarcoma (HAS) originated in the soft tissue of the genital area metastatized to the stomach and the duodenum.
We tried a method of topical injection of pure ethanol under endoscopy to stop the bleeding in this case.
This case was a 70-year-old female, who noticed a tumor in the genital area six years ago for the first time. She had this tumor extirpated and received chemotherapy after that. She got similar therapy four times thereafter and she also started radiation therapy of 60Co five months prior to admission. She was admitted this time because of the bleed-ing from the tumor in her tonsils, which was diagnosed as HAS by biopsy. Her labora-tory studies on admission revealed the findings of iron deficiency anemia.
We tried a method of topical injection of pure ethanol under direct endoscopic obser-vation, which was effective in stopping the tarry stool.
We could not find a case report of a metastatic HAS to the stomach. We could only find a case of metastatic gastric liposarcoma reported by Seki, H. et al. in 1983. The method of topical injection of pure ethanol was successfully used in a case of gastric he-mangioma, two cases of metastatic malignant lymphoma to the stomach and fifteen gastric cancer. We think this method useful whenever urgent hemostasis is necessary irre-cases of spective of whether the lesions are malignant or not.View full abstractDownload PDF (4097K) -
Hiroshi WATANABE, Takashi YASUHARA, Hiroshi KONO, Shunsuke SASAKI, Fum ...1985 Volume 39 Issue 10 Pages 870-872
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSWe report a case of pedunculated Brunner's adenoma in the duodenal bulb, which was successfully removed by an endoscopic polypectomy.
This case was a 61-year-old male without any complaints, whose abnormality was accidentally checked by an upper GI series. The laboratory studies on admission revealed no abnormalities. A polyp with a stalk was detected by ERCP and endoscopy, which was polypectomized without any complications. The resected polyp was 15×13×12 mm with a stalk of 5 mm in size. Its histology was consistent with Brunner's adenoma.
A benign tumor in the duodenum is less frequently found than a cancer. In those, however, Brunner's adenoma is most frequently observed and 347 cases were already reported till 1979. Although, we see only 38 cases in the duodenum that were endosco-pically removed by a polypectomy till Jan. of 1983.
We consider this methodendoscopic polypectomy-a diagnostic and a therapeutic pro-cedure as well. We will be able to find more cases like this by a widespread use of endoscopy and an advanced skill.View full abstractDownload PDF (2453K) -
TWO CASES OF LEIOMYOSARCOMA OF THE INTESTINE-SOME CONSIDERATIONS ON DIAGNOSTIC CRITERIA OF HISTOLOGYJunji MATSUOKA, Tsukasa OKAMOTO1985 Volume 39 Issue 10 Pages 873-875
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSTwo cases of leiomyosarcoma of the duodenum and rectum are reported. Histologi-cally, they were well-differentiated leiomyosarcoma different from leiomyoma in terms of cellular atypia, cellularity, mitotic figure and invasive growth. Some considerations on diagnostic criteria of well-differentiated leiomyosarcoma were presented and discussed.View full abstractDownload PDF (2771K) -
Kazumi NISHIDA, Masamichi HAGIWARA, Masayuki SHINODA, Tadashi HATANO1985 Volume 39 Issue 10 Pages 876-878
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA 78-year-old male with a large mass in the right abdomen was admitted to our hospital. Barium enema revealed the mass compressing the cecum upwards. A CT-scan disclosed a cystic mass with an irregular wall in the right retroperitoneal cavity. Under the clinical diagnosis of retroperitoneal tumor, an operation was performed. The mass in the retroperitoneal cavity contained brown-colored, jelly-like fluid and was merged with the cecum. Cytology of both the fluid and the surgical specimen of the cecum disclosed adenocarcinoma. The final diagnosis was appendiceal cancer. There have been no reports of appendiceal cancer rupturing into retroperitoneal cavity.View full abstractDownload PDF (2244K) -
One with a Chief Complaint of Melena and the Other with a Tumor Formation Accompanying an Internal FistulaKoji OKI, Akira TORIYAMA, Hisanori OHYABU1985 Volume 39 Issue 10 Pages 879-882
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSRecently we experienced two cases of Crohn's disease seen in young patients. In the first case, the patient visited the hospital because of melena and anemia. Based upon the findings of barium enema and a fiberscopic examination of the colon, the patient's disorder was diagnosed as Crohn's disease. An operation of right hemicolectomy including the resection of terminal ileum was done. A cobblestone appearance was observed in the removed specimen, and noncaseating epitheloid cell granuloma was demonstraed histologically.
In the second case, the patient visited the hospital complaining of lower abdominal mass with severe abdominal pain. An emergency laparotomy was carried out under the diagnosis of abscess, and it disclosed the thickened ileocecum en block, and an internal fistula was formed. We then suspected Crohn's disease of the tumor formation type with an internal fistula, and right hemicolectomy including the resection of terminal ileum was carried out. A cobblestone appearance was observed in the removed specimen and noncaseating epitheloid cell granuloma was demonstrated histologically.View full abstractDownload PDF (3976K) -
Tsukasa OKAMOTO, Yuzo UEDA1985 Volume 39 Issue 10 Pages 883-885
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSA 77-year-old male was operated on for cancer of the ascending colon. A baseball-sized cancer resembling Borrman type ft was seen in the ascending colon. Moreover, a small finger tip-sized polyp was also found in the cecum. Histologically, a well-differentiated adenocarcinoma coexistent with Schistosoma eggs of the ascending colon was revealed. Cecal polyp was histologically a carcinoma in adenoma coexistent with the same eggs in the submucosal layer.
Relationship between the elevated lesions or cancer and Schistosoma eggs in this case might suggest that the existence of the eggs caused the elevated lesions (polyp and adenoma) leading to a well-differentiated adenocarcinoma.View full abstractDownload PDF (2486K) -
Toru ISOMOTO, Shuji HIROSE, Sanae OTA, Haruo FUNAKI1985 Volume 39 Issue 10 Pages 886-890
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSWe report 3 cases recovering from severe failure of 3 organs after the operation.
The first case was a 69 year old male. Grafting operation was performed for the abdominal aortic aneurysm. After declamping of the aorta he developed severe shock which resulted in acute renal insufficiency, liver failure and cerebral lesion, and he was treated by artificial hemodialysis of as much as 41 times and artificial liver.
The second case was a 60 year old male. Esophageal transection under the left thoracotomy and transdiaphragmatic splenectomy were performed for the esophageal varices (liver cirrhosis). On the 7th postoperative day he fell into the 3rd grade level of unconsciousness of Sherlock. Moreover, esophageal and diaphragmatic suture insufficiency were accompanied, which caused severe respiratory insufficiency requiring artificial respiration for 52 days.
The third case was a 53 year old male and had a past history of right upper lobectomy and right thoracoplasty for the lung tuberculosis. For the lower thoracic esophageal carcinoma, we performed thoracic esophageal resection under the right thoracotomy and the esophagus was reconstructed by pulling up of the stomach retrosternally. After the operation he developed severe shock associated with respiratory failure and hepato-renal insufficiency. He was recovered from these complications by careful management of artificial respiration and nutrition.View full abstractDownload PDF (583K) -
Tsuyoshi YAMANAKA, Yasuhisa OKUMURA, Toshinori MATSUMURA, Hisashi MINA ...1985 Volume 39 Issue 10 Pages 891-894
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSOf 257 patients with mechanical ileus treated at the Department of Surgery of the Miyakonojo National Hospital during the 10 years since 1973, 225 (87.5%) had simple ileus and 32 (12.5%) had complications. Two hurdred and five patients (91.2%) of these 225 with simple ileus had adhesion ileus. These patients had a history of previous operation for gastrectomy, ileus, or appendectomy. Tumorous ileus was observed in approximately half of the patients without any previous surgical treatment.
Sixty-four (28.4%) of the 225 patients with simple ileus and all of the 32 patients with complications required surgical treatment. As for the operation, 30 patients (46.9%) with simple ileus were surgically treated for separation of adhesions, enterectomy in 14 (21.9%), and enterectomy in 18 (56.2%) with complications.
Patients with simple ileus were treated surgically evenly for the period from the first day to the 5th day, and approximately half of patients with complicated ileus received operations on the first day or the following day. Seven patients (2.7%) died mostly due to sepsis.View full abstractDownload PDF (591K) -
Yasukazu NAKA, Koichi NAKAMOTO, Kazushige HAYASHI, Takeshi YONEZAWA, M ...1985 Volume 39 Issue 10 Pages 895-899
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSWe reviewed eight patients with intrahepatic stones (3 men and 5 women, 36 to 74 years of age) experienced in the Yokohama National Hospital over the last 5 years. Both intra- and extrahepatic stones were noticed in 6 patients and only intrahepatic stones in 2 cases. As to the location of the stone in intrahepatic biliary system, 5 patients had the stones in the left intrahepatic bile ducts and 3 had them in the both right and left intra-hepatic bile ducts. Ductal strictures of intrahepatic billiary tract were detected in 3 patients and no ductal stricture in 5 patients. Ductal strictures were seen in the biliary tract of left lateral segment in 2 patients, right hepatic duct in one patient and common hepatic duct in one. All patients having no ductal stricture underwent cholecystectomy with choledochotomy and drainage, one with transduodenal papilloplasty and one with hepatic lobectomy. Although complete removal of intrahepatic stones was not done in 2 of the cases, they remained asymptomatic in the follow-up period. Patients with ductal stricture underwent choledochotomy, one with hepatic lobectomy and one had only common hepatic duct drainage. Intrahepatic residual stones were noted at time of the discharge in 2 of the 3 cases. Although one of them was asymptomatic, another became symptomatic again after 6 months. The case was treated with transcutaneous transhepatic cholangioscopy and we finally removed all the stones.View full abstractDownload PDF (2248K) -
Hiroko ISHIKAWA, Junichi NOGUCHI, Mutsumi ENDO, Taro KAWAZOE, Muneaki ...1985 Volume 39 Issue 10 Pages 900-904
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSAcid aspiration pneumonia, which is caused by pulmonary aspiration of stomach contents, is one of the most dangerous anesthetic complications even today. In order to prevent this complication, an attempt has been made to increase pH values of gastric juice. Recently, much attention has been paid to the use of histamine H2 receptor antagonist for this purpose.
We investigated the effect of Ranitidine(SN-301), a new H2 receptor antagonist, on the volume and pH of gastric juice in patients who underwent surgery under general anesthesia. Ranitidine 50mg was given intramuscularly to 58 patients before induction of anesthesia, and gastric juice was collected after the induction, to measure the volume and pH. Results were compared with those of the patients in the control group who had not been given Ranitidine. The results indicated that the patients in the Ranitidine group showed significant decrease in the gastric volume, and gastric pH values were significantly higher than those of the control group. Among the Ranitidine group, gastic volume in the patients under 40 years of age was larger, and pH values were lower than those in the patients above 40 years of age. Similar tendency was also observed in the control group.
When the effects were compared in terms of the time of administration, the gastric pH values were significantly lower in patients who received the drug less than 60 minutes before anesthesia than those who received the drug more than 60 minutes before.
We already reported the efficacy of Cimetidine for the prevention of acid aspiration pneumonia. We have now shown that Ranitidine, a new histamine H2 receptor antagonist, is also a useful drug for the prevention of acid aspiration pneumonia when it is administered before induction of anesthesia. However, the analysis in terms of age and administration time factors has indicated that even if Ranitidine is administered, danger of aspiration still has to be taken into account for young patients and those anesthetized within 60 minutes after the drug administration.View full abstractDownload PDF (592K) -
II. Bone Marrow 2. Immature Neutrophils and Mono-cytesMakoto AOKI, Naohiro MURAYAMA1985 Volume 39 Issue 10 Pages 905-908
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDownload PDF (4157K) -
1985 Volume 39 Issue 10 Pages 909
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDownload PDF (125K) -
1985 Volume 39 Issue 10 Pages 909a-910
Published: October 20, 1985
Released on J-STAGE: October 19, 2011
JOURNAL FREE ACCESSDownload PDF (206K)
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