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Volume 40, Issue 3
Displaying 1-17 of 17 articles from this issue
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N. Inatsugi1987 Volume 40 Issue 3 Pages 229-238
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe purpose of this study is investigation for the pathogenesis of the ischemic colitis in rats.
An experimental model of ischemic colitis was designed in 140 rats by ligation of the mesenteric vessels in the colon and closure in the anal canal. The effects on blood flow in the colonic wall with mesenteric vascular ligation and with increasing the intraluminal pressure by colonic distension were studied with hydrogen clearance method. Histological examinations for ischemic lesion were undertaken in sacrified rats.
The results were as follows : 1) The incidence of ischemic ulcer was higher in the group of ligation of the mesenteric vessels in the colon and closure in the anal canal simultaneously than in the group of the vascular ligation or the anal closure alone. In the group of which anals were closed at 6 hours after ligation of the mesenteric vessels the incidence was decreased markedly. 2) The colonic blood flow at 1.5 hours after mesenteric vascular ligation fell remarkably and recovered rapidly. The blood flow was significantly diminished by an intraluminal pressure of over 10 mmHg. 3) Various ischemic changes of the colon similar to human ischemic colitis could be produced in rats by ligation of the mesenteric vessels and/or closure of the anal canal. 4) These results seemed to suggest that in the pathogenesis of the ischemic colitis an important role be played by relationship between intraluminal pressure and colonic blood flow.View full abstractDownload PDF (2302K) -
Part II: Motility of the Ileocecal Region and the Response of the Intestine to EatingK. Murakami1987 Volume 40 Issue 3 Pages 239-247
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe mechanism of the ileocecal transit of man is less known because of the technical difficulties of the examination of that region. And the response of the human intestine to eating is not well known, either.
I have already reported a new isotopic method for measuring colonic transit in man using 99mTc-DTPA in combination with a gamma camera linked to a computer, which has been named "colonoscintigraphy" (J Jap Soc Coloproct 40 : 18-26, 1987). And it was thought to be a useful method of physiological and clinical research for determining long-term continuous colonic transit in man.
To examine the ileocaecal transit of man, colonoscintigraphy including the terminal ileum was carried out in 8 cases. And 5 subjects were let to eat food during the colonoscin-tigraphy to recognize the response of the intestine to food.
As a result, the colonic mass movement following the transit of terminal ileum was observed and the immediate response at both terminal ileum and large intestine to eating was recognized.View full abstractDownload PDF (512K) -
M. Iizuka, M. Chiba, K. Igarashi, A. Nagasaki, H. Arakawa, O. Masamune1987 Volume 40 Issue 3 Pages 248-253
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSerum cholinesterase (ChE) activity was studied in 34 cases of ulcerative colitis (UC), and the following results were obtained.
1) Serum ChE activity was directly proportional to the levels of serum albumin and hemoglobin, while it was inversely proportional to the levels of CRP, ESR, WBC, and serum α2 globulin. Of these, the highest correlation was observed between serum ChE activity and the level of serum albumin.
2) Serum ChE activity was decreased significantly in the active stage of UC compared with that in remission. This tendency of decrease in the active stage was more pronounced when the lesion became more extensive and the colitis became more severe.
3) The serum ChE/albumin ratio was also decreased significantly in the active stage of UC in comparison with that in remission. From these results, serum ChE activity was found to be a sensitive index of UC activity, so that serum ChE should be added as a new index to the list of conventional UC severity indices.View full abstractDownload PDF (335K) -
M. Izumi, M. Nishizawa, K. Nomoto, T. Hosoi, T. Okada, K. Yamada, T. M ...1987 Volume 40 Issue 3 Pages 254-260
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe following results were obtained from on analysis of colon cancers (155 cases, 166 lesions) detected through X-ray and endoscopy from among apparenthy healtly examines.
1) The proportion of colon cancers missed upon initial examination was 1.6% among early cases and 4.7% among advanced cases.
2) With regard to complaints, detectability in terms of hemorrhage was 8.4%, while asymptomatic detectability was 1.8%, the proportion of early cancers being 32% in the former and 91% in the latter.
3) On the basis of 21 cases of follow-up cancers detected and analyzed retrospectively, sigmoid cancers wese considered most likely to be missed. Sessile and flat-topped elevations were also more likely to be missed when X-rays taken at initial examination were sciutini-zed.View full abstractDownload PDF (380K) -
A. Munakata, M. Ishiguro, S. Iwane, M. Ohta, S. Nakaji, S. Tsuchida, Y ...1987 Volume 40 Issue 3 Pages 261-267
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe incidence of colonic diverticular diseases and dietay fiber intake among the popula-tions of 5 prefectures (Aomori, Niigata, Tokyo, Hyogo and Fukuoka) in Japan were investi-gated. Data on daily food intake were obtained from the National Nutrition Survey, and the dietary fiber content in each type of food was estimated by dietary fiber analysis according to Southgate's method. The incidence of colonic diverticular disease in Aomori in 1985 was lower than those in other provinces. The daily dietary fiber intaks in Aomori, Niigata, Tokyo, Hyogo and Fukuoka in 1983 were 21.1, 17.7, 17.0, 16.2, 16.4g/day, respectively. The incidence showed a negative correlation with fiber intake, and not with protein or fat intake. These results suggest that dietary fiber is involved in the pathogenesis of colonic diverticular disease.View full abstractDownload PDF (376K) -
H. Tsuji, S. Fukuda, T. Satoh, H. Nishida, S. Mitsufuji, M. Takamasu, ...1987 Volume 40 Issue 3 Pages 268-272
Published: 1987
Released on J-STAGE: December 03, 2009
JOURNAL FREE ACCESSIn a polypectomy series carried out at our institute, 182 colonic adenomas and 23 early colonic cancers (14 carcinomas in situ and 9 invasive carcinomas) were analyzed, and the following results were obtained:
1) The mean ages of patients with adenoma and early cancer were almost the same-about 60 years. The sex ratio of males to females was about 3.5 to 1 for both adenoma and early cancer patients.
2) The proportion of early cancer cases was 11.2% in our series.
3) Most adenomas and early cancers were situated on the left side of the colon.
4) The proportion of early cancers was higher toword the anal side of the colon than toward the oral side.
5) With increasing polyp size, the incidence of early cancer increased ( ≤ 4mm: 0%, 5-9mm: 3.2%, 10-19mm: 24.7%, ≥ 20mm: 40.0%). Invasive cancers were not found in lesions less than 9mm in diameter.
6) The average size of the polyps was only slightly larger on the anal side, suggesting that the malignancy rate for the same-sized polyp may be higher on the anal side.
7) Most adenomas and early cancers were peduaculated or semipedunculated in shape, but the risk of malignancy was higher in sessile types.View full abstractDownload PDF (262K) -
A. Yamaguchi, T. Ishida, T. Kumaki, M. Kato, H. Sekino, M. Kiriyama, F ...1987 Volume 40 Issue 3 Pages 273-278
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe presence of tissue hCG in colorectal carcinoma was studied immunohistochemically in 181 tumors using the PAP method. Thirtyfour neoplasms (18.1 %) contained hCG-positive tumor cells. The sensitivity for moderately and poorly differentiated adenocarcinomas was higher (30%) than that for well differentiated adenocarcinoma. In this study, lymph node, liver or peritoneal metastases were present more frequently in 26 %, 54 % and 80 % of hCG-positive tumors compared with 10 %, 12 % and 13 % of hCG-negative tumors. Also, the CEA doubling time of liver metastasis from hCG-positive colorectal cancer was shorter than that of hCG-negative cancers. Also, the survival rate for patients with hCG-positive colorectal cancer was very low. These results suggest that the presence of tissue hCG is associated with an aggressive from of tumor growth and a poor prognosis.View full abstractDownload PDF (1427K) -
M. Senjuh, K. Makiyama, H. Haga, Y. Mizuta, K. Kubo, S. Funatsu, K. In ...1987 Volume 40 Issue 3 Pages 279-286
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSCells positive for IgA, IgG and IgM in the rectal mucosa of patients suffering from ulcerative colitis were estimated by direct immunoperoxidase staining. The materials were 45 biopsied rectal specimens which were obtained from 27 patients with ulcerative colitis, and six speci-mens of grossly normal mucosa from patients with active ulcerative colitis which were distant from the apparently inflamed mucosa. Eleven rectal biopy specimens from patients without organic bowel disease were processed as normal controls. In the active stage, the numbers of cells staining positively for IgA, IgG and IgM were significantly increased compared with normal control materials. IgG-and IgM-positive cells were especially increased in number, the former by 4.3 times and the latter 4.5 times in comparison with normal controls. In the normally appearing mucosa separated from inflamed mucosa, IgA-positive cells decreased and IgG-positive cells were increased. Abnormalities of intestinal mucosal immunity in ulcerative colitis were thus suggested to occur not only in inflamed mucosa but also normally appearing mucosa.View full abstractDownload PDF (3338K) -
H. Ohoke, K. Yanagita, T. Yasushi, K. Tsujita, Y. Nagasawa, T. Ohogai, ...1987 Volume 40 Issue 3 Pages 287-290
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 74-year-old man was operated as a cancer originated from anal fistula. Macroscopic and microscopic examinations revealed the adenocarcinoma in duplicated rectum which invaded into the proper muscle layer. This case satisfied all of the criterion for the diagnosis of duplication of the alimentary tract proposed by Macleod and Purves in 1970.
Cancer of the rectal duplication has been reported fitstly by Fletcher and Waring in 1900. Only a few cases have been reported subsequently. There were 7 cases in the Japanese literatures, 6 cases by Sumikoshi and one case by the author.
These 7 cases showed the clinical feature of anal fistula with cancer. The differential diagnosis of fistula cancer from the duplication with cancer appeared to be very difficult preoperatively in any of these cases.View full abstractDownload PDF (4144K) -
T. Morodomi, H. Isomoto, Y. Murakami, T. Kobatake, K. Shirouzu, T. Kak ...1987 Volume 40 Issue 3 Pages 291-296
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe patient was a woman aged 30 years. She was diagnosed as having ulcerative colitis at the age of 14 years, and she had been receiving medical treatment for 16 years thereafter. However, she had an episode of severe diarrhea and abdominal pain and was admitted to hospital.
Despite the application of internal treatment, the transverse colon developed into megacolon, so we performed a total colectomy. The resected colon was very short, with a 10-cm-long and rather deep ulcer in the mesenteric side. On the basis of the pathohistological findings, we reached the following conclusions.
After long-term infilammation due to U. C., an ischemic lesion developed. As a result, blood vessels, proper muscles and nerves were damaged, resulting finally in shortening of the colon and a longitudinal ulcer. In addition, the gas pressure in the bowel increased, and megacolon occurred.
We feel that this case provides a very interesting example of the development of toxic megacolon.View full abstractDownload PDF (6435K) -
K. Kotake, Y. Koyama, C. Sekiguchi, J. Matsui, S. Hishinuma, K. Yokoi, ...1987 Volume 40 Issue 3 Pages 297-302
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAngiodysplasia of the colon has been reported with increasing frequency as a causative disease of lower gastrointestinal bleeding, occurring mainly in the right side of the colon and in elderly individuals.
We encountered a patient with angiodysplasia of the upper rectum, presenting with chronic repeated peranal bleeding, treated by local excision of the lesion. Both colonoscopy and angiography were valuable methods for identifying the lesion, and on laparotomy, intraoperative colonoscopy was essential for localizing the lesion and locating any other lesions. Also we dascribed the utility of specimen angiography in identifying minute angiodysplasia.View full abstractDownload PDF (4318K) -
Y. Kamiyama, I. Sasaki, Y. Funayama, M. Imamura, H. Naito, K. Fukushim ...1987 Volume 40 Issue 3 Pages 303-307
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe experienced two cases of small bowel perforation in patients with Crohn's disease. Case 1. A 34-year-old male was admitted to the Tohoku University Hospital with a sudden onset of lower abdominal cramp. Plain abdominal X-ray revealed right subphrenic free air. Laparotomy revealed generalized peritonitis due to a perforated ileum. About 100 cm of the diseased ileum including the area of perforation was resected. Pathological examination revealed severe regional enteritis (Figs. 1, 2). Case 2. A 22-year-old male was admitted to the Tohoku University Hospital with a sudden onset of severe abdominal pain. Abdominal muscular guarding and leucocytosis suggested acute peritonitis. Laparotomy revealed diffuse peritonitis due to a perforated ileum. About 100 cm of the diseased ileum including the perforation was resected. Pathological examination revealed severe regional enteritis.
Small bowel perforation in Crohn's disease is rare because of the nature of the inflam-matory process. Several different surgical approaches have been performed for free perforation of the bowel in Crohn's disease. We propose resection of the diseased bowel including the perforation as the procedure of choice because of the low rates of associated postoperative mortality and complication.View full abstractDownload PDF (4374K) -
T. Kawai, K. Hojo, K. Kawai, M. Tada, M. Ishii, Y. Oba1987 Volume 40 Issue 3 Pages 308-313
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSince today colon cancer is on the increase, attention has been drawn to the use of fecal occult blood tests (F. O. B. T.) as a nears of screening have for the disease. However, most of the currently available chemical tests for F. O. B. T. have problems with sensitivity and specificity. Under these circumstances, vaious reagents for immunological F. O. B. T. which react solely with human Hb and specifically have been developed. We carried out a clinical study on Monohaem, one of these reagents, using a multicentral approach. The false-positive rate in healthy volunteers without diet restriction was 8.1% (16/197), indicating the high specificity of this reagent as compared with conventional chemical tests. The detection rate of colon cancer was as high as 91.4% (74/81), confirming the high sensitivity of this test reagent. From these findings, the possibility of early detection of cancer was suggested. In addition, it was found that gereally satisactory results could be obtained by performing tests on 2 consecutive days, unlike conventional methods which require tests ove 3 days. The Monohaem test is an immunological approach utilizing monoclonal antibody. Monohaem can be used easily simply by adding a washing process to conventional chemical tests, and was also confirmed to be a useful reagent for the mass screening of colon cancers.View full abstractDownload PDF (380K) -
1987 Volume 40 Issue 3 Pages 314-319
Published: 1987
Released on J-STAGE: June 05, 2009
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1987 Volume 40 Issue 3 Pages 320-332
Published: 1987
Released on J-STAGE: June 05, 2009
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1987 Volume 40 Issue 3 Pages 333-335
Published: 1987
Released on J-STAGE: June 05, 2009
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1987 Volume 40 Issue 3 Pages 336-360
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (2300K)
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