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Volume 28 (1975)
- Issue 4 Pages 303-
- Issue 3 Pages 207-
- Issue 2 Pages 105-
- Issue 1 Pages 1-
Predecessor
Volume 28, Issue 4
Displaying 1-18 of 18 articles from this issue
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R. Kita, T. Ozawa, E. Kim, S. Miyamoto1975 Volume 28 Issue 4 Pages 303-307,392
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThree cases of amoebic colitis were reported.
Case 1) A 70-year old man complaining of sanguinous stool, no diarrhoea. Case 2) A 57-year old man complaining of ileocecal pain and muco-sanguinous stool. Case 3) A 67-year old man complaining of sanguinous stool and diarrhoea 12 times a day, who had amoebic colitis 30 years ago in Burma.
In sigmoidscopic findings, 2 cases showed shallow ulcerations with bleeding and intact inter-ulceration mucosa, 1 case showed findings indistinguishable from nonspecific ulcerative colitis. In all cases, Entamoeba histolytica was seen in their rectal biopsies.
The need for continuing awareness of amoebiasis as a possible cause of chronic bloody diarrhoea was emphasized.View full abstractDownload PDF (5069K) -
Y. Uchida, S, Hayashi1975 Volume 28 Issue 4 Pages 308-313,392
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA twenty year old male, a motor truck driver.
As he jumped off from the truck, he rode on the top of fire-hook-handle which he grasped with hand, and it entered his anus.
On the day after admission, the abdomen was explored, and a rectum 8cm from the dentate line presented a ragged perforation about 2cm in diameter.
Four days after operation he had a high fever, so he was given a Sulpyrine injection subcutaneously.
Soon after injection he felt in shock, three hours after he died in spite of all anti-shock therapies.
Further this literature mentioned the manegement of sigmoid and rectum perforation, and secondary effect of the drugs.View full abstractDownload PDF (2041K) -
S. Kodaira, K. Hojo, Y. Koyama1975 Volume 28 Issue 4 Pages 314-321,393
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAt NCC Hospital during 13 year period 1962-1974, 349 patients of carcinoma of the rectum and anal canal were surgically treated.
In these cases we investigated the lymphatic metastases in relation to several pathological characteristics of the primary tumor and its effect on prognosis.
In all cases of this series, lymphatic metastases were found in 51.8 per cent. The location of tumor had not influence on frequency of lymphnode metastasis.
In this study, lymphatic drainage of the rectum was divided into two ways; superior spread and lateral spread. Metastases of lateral pedicle was found in 13.4 per cent of all cases.
Distribution of lymphnode metastases according to location of tumor, relationship of site of tumor to lateral lymphatic spread, and frequency of lymphnode metastases in relation to the depth of invasion and size of tumor were also studied.
Five-year survival rate of all curatively resected cases was 51.5 per cent. Five-year survival rate for cases without lymphatic metastases was 62.5 per cent and this was reduced to 26.8 per cent for those with lymphatic metastases. In Astler's A cases, five-year survival rate was 94.9 per cent, in B1 cases 88.9 per cent, in B2 cases 57.6 per cent, in C1 cases 29.6 per cent, and in C2 cases 26.7 per cent.View full abstractDownload PDF (575K) -
M. Tada, S. Takemura, [in Japanese], [in Japanese], [in Japanese], [in ...1975 Volume 28 Issue 4 Pages 322-326,393
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSFrom the point of clinical and pathological views, polypous lesions of the colon have been considered as one of the precancerous states because of high risk of their malignant changes and high frequency of coincident cancer.
A 35-year-old male in our clinic, complaining of anal bleeding, was detected to have diffuse polyposis spreading all over the colon and rectum by radiological and endoscopical examinations. Subtotal colectomy except the rectal region was done in fear of the malignant changes of polyps. After that, the remaining polyps in the rectum were polypectomized using the local injection of 95% ethanol. Compared with the widespread diathermic snare, this method is much safer and ulceration at the site of polyp heals as rapidly as within 2 or 4 weeks, though the resected polypp cannot be recovered. Therefore, this endoscopical local injection is thought to be useful for the treatment of the remaining polyps after subtotal colectomy.View full abstractDownload PDF (3412K) -
T. Kajitani1975 Volume 28 Issue 4 Pages 327-330,394
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDuring the years from 1964 to 1973, there were 37 cases of mucosal (m) or submucosal (sm) cancer among 820 cases of single colonic or rectal cancer of curative resection found in the Cancer Institute Hospital, Tokyo. Of these 37 cases, 19 were mucosal and 18 were submuosal cancer, and lymph nodes were involved in only one of submucosal cancer cases. In these 37 cases, 13 tumors were larger than 2.0cm in superficial extension. The pedunculated, protruded, or elevated type is characteristic for mucosal and submucosal cancer of the large intestine. The 5-year survival rate in these 22 cases was 100%.
The Dukes A group accounted for 17.8% of the cases of curative resection and their 5-year survival rate was 93.6%. The Dukes A might be designated as early cancer but this classification is surgicopathological, and clinical discrimination of the Dukes A is quite difficult.
Clinical measurement of the size of a tumor is quite simple. Tumors of 2.0cm or less in diameter are mostly mucosal and submucosal cancer, and 5-year survival of patients with such a cancer is 100%. Tumors larger than 2.0cm are not found infrequently in mucosal and submucosal cancer, and patients with such a cancer show a good prognosis.
Mucosal and submucosal concer should be diagnosed histologically but clinical assumption is also possible. Designation of mucosal and submucosal cancer is appropriate for the standard of early cancer of the large intestine, bun cases showing the presence of clinical metastasis should be excluded from early cancer.View full abstractDownload PDF (278K) -
H. Shirakabe1975 Volume 28 Issue 4 Pages 331-335,394
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSEarly cancer of the colon is defined that invasion of cancer is limited to mucosa and submucosa of the colon. For diagnosing early cancer of the colon, small lesion, even less than 1cm, should be detected at the first X-ray examination, and the lesion more than 1cm should not be missed. To estimate frontal and profile view of radiograph of the lesion, it is possible to assign malignancy, however, final diagnosis should be made by endoscopic biopsy.
Hojo reported relation between malignancy and size of colonic polyp i.e. malignancy of colonic polyp proportionally increases according to its size. 32 to 50% of colonic polyp larger than 2 cm in diameter are cancer or so-called "carcinoma-in-situ".
Maruyama reported that stalk of colonic polyp should be definitely demonstrated on the radiograph, because polyp with stalk is benign lesion or early cancer. And a depression on the surface of the lesion without stalk is indicative for early or advanced cancer.
The fact that in the majority of flat elevated lesion, cancer infiltrates submucosa already, should be specially noticed.View full abstractDownload PDF (411K) -
D. Jinnai1975 Volume 28 Issue 4 Pages 336-338,395
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESS1. Establishment of definition of early cancer in the large intestine, by which minor surgery (wedge resection or polypectomy) is available and allowed, is desirable, because of severe postoperative dysfunction of urination and colostomy after Miles operation, which is generally used for rectal cancer.
2. Five year survival rate of early cancer in the large intestine should be higher than 90-95% and its frequency in all cases be approximately 10%.
3. Definition of early cancer in the large intestine should be stricter than that in the stomach.
4. Definition of early cancer should be determined by the findings which can he clearly detected preoperatively.
5. Early cancer in the large intestine should be smaller than 1cm. in diameter and more shallow than submucosal layer in the deepest invaded layer of the wall.
6. It is to be desired that definition of early cancer in the large intestine has the same scale as that in the early stomach cancer.View full abstractDownload PDF (262K) -
T. Muto, K. Matsumaru, N. Kamiya, Y. Horie, K. Ishikawa1975 Volume 28 Issue 4 Pages 339-344,395
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAdenoma-early cancer relatiotship was studied from the histological investigation of a large number of adenomas and carcinomas arising in adenomas of the large bowel. It was strongly suggested that the majority of colonic cancers evolved from preexisting adenomas. The concept was supported by the evidence that most focal cancers (carcinoma confined to the mucosa) were found in otherwise benign adenomas. It was also suggested that as cancers spread through the bowel wall so they expand on the mucosal surface and tend to destroy surviving benign adenomatous tissue. The process of malignant transformation in an adenoma may be variable in individual adenomas.
Out of 100 adenomas removed through colonosope there were 18 early cancers, among which 16 cancers had definite histological evidence of adenoma origin. The value of colonoscopic polypectomy was emphasized in the treatment of colorectal polyps and in the study of adenomacancer sequence.View full abstractDownload PDF (2406K) -
A. Yamada, C. Yazawa, S. Kobayashi, K. Hamano, T. Kosaka, M. Onda1975 Volume 28 Issue 4 Pages 345-348,396
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSOut of our 39 early carcinoma cases of the colon, 34 cases, on whom barium enemaexam was done before operation, are divided into 4 groups, i.e., pedunculated, semipedunculated, sessile and ulcerative ones. To begin with, the correlation between size and invasion of carcinoma is studied. And existencediagnosis is discussed, and thereafter qualitative diagnosis is also discussed.
We have compared our 34 early carcinoma cases with 59 benign polyp ones. With regard to the group, in pedunculated ones, differencial diagnosis is difficult because of no relations between them, but in semipedunculated and sessile ones, differential diagnosis is rather easy because of their different sizes. The uneveness of the surface has correlation with histologic findings, but it has no connection with differential diagnosis between malignancy and benignancy.
With regard to the depth of invasion, the correlation between early carcinoma cases and 23 advanced carcinoma cases (protruding type) is discussed: Almost all cases of the pedunclated type are carcinoma in situ. The sessile cases more than 25 mm in size are advanced and almost all cases that make ulcer on their surface are also advanced.
In the conclusion, it is very important to delineate the surface of the lesion mimutely.View full abstractDownload PDF (1690K) -
D. Aoyama1975 Volume 28 Issue 4 Pages 349-351,397
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe method of radiological examination to diagnose the early cancer of the colon is the preparation by Brown's method, the injection of " Coliopan " (antispasmolytic remedy) before the radiological examination and the double contrast method with Barium of 65% (w/v).
The macroscopic findings of the early cancer of the colon are limited in the prominent lesions. Therefore, it must be very important to find out these lesions.
The colonoscpy is not so convenient for the routine examination of the colon, and in the radiological examination even small polyps must not be overlooked.
Now in Japan, the methods for finding out the early cancer of the colon are almost perfect.
On the other hand, the complaints of the patients with the early cancer of the colon are still unknown or may be rather none. Those problems are now very important.
In the radiological examination of the so-called "Colon Syndrom" (by Prof. T. Hayashida), the cases with the small "simulating" early cancer of the colon with histological evidence of no metastasis of lymph nodes are demonstrated.View full abstractDownload PDF (1978K) -
M. Maruyama, [in Japanese], [in Japanese]1975 Volume 28 Issue 4 Pages 352-357,397
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe radiologial diagnosis of early carcinoma of the large bowel resolves itself into the following six points.
1. Detailed analysis of macroscopical characteristics is of no use for the radiological differential diagnosis of polypoid lesions of the large bowel.
2. It is the most important procedure first to distinguish whether a polypoid lesion is pedunculated or sessile, and, then, whether it has central depression or not, when the lesion is sessile.
3. It is impossible to decide radiologically whether a pedunculated lesion is benign or early carcinoma. There is no advanced carcinoma in pedunculated lesions.
4. A sessile lesion within 1.0 cm in the largest diameter and without central depression is most probably diagnosed as early carcinoma.
5. A sessile lesion with central depression should be diagnosed as advanced carcinoma, Borrmann Type II, rather than eatly carcinoma, Type IIa+IIc, regardless of its size. There is no benignancy in the lesions with central depression.
6. It is very difficult to decide invasion depth of carcinoma by the extent of depressed sign (deformity) of the bowel wall, although early carcinoma reveals generally a slight sign of it.View full abstractDownload PDF (7044K) -
H. Watanabe, K. Shoji, S. Yamagata1975 Volume 28 Issue 4 Pages 358-361,398
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDiagnostic methods for the detection of cancer of the colon and rectum were compared and the best way to find cancer of the colon and rectum in its early stage was investigated. On the other hand, the relative survival rate was calculated and the long term prognosis of cancer of the colon and rectum was examined. The results are summarized as follows:
1)So-called early cancer of the colon and rectum, of which invasion was limited to the mucosa and submucosa, can be correctly diagnosed before surgery and/or polypectomy when its diagnosis is made by the combined application of both biopsy and cytological examination under direct vision.
2)Cancer of the colon and rectum can be cured when it is detected and resected in the stage of Dukes A, in which growth is limited to the wall of the colon and rectum without any metastasis.View full abstractDownload PDF (310K) -
S. Kobayashi, Y. Yoshii1975 Volume 28 Issue 4 Pages 362-364,398
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA total 36 cases of early colorectal carcinoma were collected at the Aich Cancer Center Hospital during the period 1965 to 1973. Early colorectal carcinoma is defined as a lesion that cancer cells are confined to the mucosa or/and submucosa regardless of regional lymph node involvement.
On gross specimen, a protruded lesion was predominant in early carcinoma; 100% in "m" lesion and 74% in "sm" lesion. On the other hand, an ulcerated lesion was more common in early advanced carinoma; 88% in "pm" lesion and 94% in "ss" lesion. Diagnostic accuracy of endoscopic examination was 46.2% in "m" lesion and 82.4% in "sm" lesion. Endoscopic misinterpretation as a benign polyp was made in 10 cases of early colorectal carcinomas ; 7 of "m" lesion and 3 "sm" lesion. The fact suggests that endoscopic observation alone does not always help to distinguish early colorectal carcinoma from benign polypoid lesion.
Endoscopic biopsy and cytology are, therefore, of great value in establishing a differential diagnosis of those lesions and in detecting early colorectal carcinoma. Furthermore, currently available technique for colonoscopic polypectomy plays an important role in not only making a definitive diagnosis but also treatment of a pedunculated polypoid lesion of the large intestine.View full abstractDownload PDF (273K) -
S. Tsuchiya, [in Japanese], [in Japanese], [in Japanese], [in Japanese ...1975 Volume 28 Issue 4 Pages 365-368,399
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSmall sessile tumour and villous adenoma of the rectum are best treated first by complete local resection. This facilitates thorough examination of the lesion. The nature and the extent of the tumour can be thus accurately revealed. If it is known to be malignant with deep invasion, further radical surgery is mandatory. But, if it is benign or superficial, unnecessary radical operation should be avoided. Technically there are three methods of avail.
1) transanal resection:suitable for low lying lesion.
2) transsphincteric resection (Y. Mason):the exposure is excellent. The sphincter and the levator are divided together with the full-thickness of the rectal wall, but no anorectal dysfunction results, provided that the wound is accurately sutured in layers.
3) transsacral resection (Kraske):the rectum is exposed dividing the levator and pelvic fascia, but the sphincter and puborectalis are retained intact. It also leaves the patient with normal anal function.View full abstractDownload PDF (4917K) -
T. Takahashi, S. Yamada1975 Volume 28 Issue 4 Pages 369-372,399
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAlmost all people have the idea that the cancer limited to mucosal or submucrsal layer of the intestinal wall should be defined as an early intestinal cancer, We can recognize the early carcinoma with high accuracy by realizing the shape and the largest diameter of the lesion, that is, pedunculated, subpedunculated, sessile, protruded with central depression and less or more than 2.0cm in diameter.Then we are preparing some methods of treatment for the early intestinal carcinoma which are variable with the combination of shape and diameter of the lesion. We must consider the frequency of the lymphatic metastasis, even if we are treating the early carcinoma.View full abstractDownload PDF (330K) -
K. Hojo1975 Volume 28 Issue 4 Pages 373-376,400
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSOn the past experiences of our clinics, surgical methods how to treat the cancers at the early stage were discussed.
"Local excision" such as polypectomy, transanal or transsphincteric removal of the tumor may be well enough curable foe these cases in which the cancer growths are limited within the mucosa. But, at those cases the cancer involved into the submucosal layer, one must carry out such larger and radical operations as segmental colectomy, lower anterior resection, pull through procedure or abdominoperineal resection.View full abstractDownload PDF (329K) -
M. Takano, Y. Sumikoshi, M. Okada, M. Sumie, J. Jin, H Sakata, [in Jap ...1975 Volume 28 Issue 4 Pages 377-382,400
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDue to the specific anatomical location, the early cancer of the lower rectum and the anus characteristic features in its form, symptoms, diagnosis and surgical treatment.
The epithelium of the area turns from the columnar epithelium of the rectal mucosa to the stratified cuboidal epithelium of the so-called cloacogenic zone, further to modified squamous epithelium of the anoderm and finally to stratified squamous epithelium of the perianal area. Various types of early cancer are to originate from those diversified epithelia.
The early cancer of the area might be difined as those which is not exceeding more than the musculus submucosae ani.
The early cancer of the area is relatively fixed well to the underlying tissues and is forced to be burshed by the passage of the stool so that it shows flatly elevated form withlittle mobility.
Villous adenoma frequently is the precursor of the cancer.
Its treatment should be decided deliberately on the basis of the pathological features of the tumor obtained by the total biopsy.
It is because the radical operation the area inevitably sacrifices the total function of the sphincter.View full abstractDownload PDF (4775K) -
1975 Volume 28 Issue 4 Pages 383-390
Published: 1975
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (635K)
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