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Volume 40, Issue 4
Displaying 1-25 of 25 articles from this issue
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Y. Mukuboh1987 Volume 40 Issue 4 Pages 361-368
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSBetween 1968 and 1986, 71 cases of colorectal cancer showing submucosal invasion were experienced.
These 71 cases could be divided into 3 groups ; (I) resection (34 cases), (II) resection after polypectomy (24 cases), (III) polypectomy only (13 cases).
Morphologically the tumors could be classified into 5 types ; type I p (pedunculated), type I s (sessile), type II a. (elevated), type II a+ II c (elevated with depression) and type if c (depres-sive).
In group (II), there were no residual cancer cells or lymph node involvement with the exception of 4 piecemeal polypectomized cases.
From consideration of morphology, size and pathology, the indication for polypectomy and/or surgical treatment was decided.
Types for which polypectomy was indicated were (a) type I p (well differentiated adenocarcinoma) and (b) type I s and type IIa (well differentiated adenocarcinoma less than 20 mm in size).View full abstractDownload PDF (590K) -
H. Toriya, S. Arima, K. Futami, H. Uchida, T. Umeno, H. Shimura, T. Ya ...1987 Volume 40 Issue 4 Pages 369-379
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe have experienced 63 cases of Crohn's disease over the last 5 years, and 51 of these cases were complicaed by perianal lesions, such as periproctal abscess or anal fistula, anal ulcer or fissure and anal skin tag. Twenty-two affected patients had noticed perianal lesions before suffeing from the gastrointestinal symptoms of Crohn's disease.
The incidence of perianal lesions was highest in patients with colonic Crohn's disease. In particular all patients with rectal Crohn's disease had perianal complications without exception.
The most remarkable features of perianal lesions in Japanese patients with Crohn's disease is that periproctal abscess or anal fistula occurs more frequently than anal ulcers, fissures or skin tags. They tend to have multiple fistulas and their secondary orifice is situated far from their anal margin in comparison with ordinary anal fistula.
Upon rectal mucosal biopsy, epithelioid granuloma was found in only 29% of all patients with perianal lesions, while it was found in 60% of patients with rectal Crohn's disease and 53% with anal ulcer or fissure.
We therefore conclude from these results that careful microscopic and macroscopic observations of perianal lesions are essential for the early diagnosis of Crohn's disease.View full abstractDownload PDF (2080K) -
M. Takano, Y. Matsuda, M. Matsuda1987 Volume 40 Issue 4 Pages 380-385
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSProctalgia fugax is a peculiar disease which occurs suddenly without any warning and also disappears by itself in a few minutes without leaving any evidence. In these respects, the disease is different far from other usually observed organic diseases. The cause of the disease has not been definitely ascertained nor universally approved.
However, 32 cases of which I have experienced showed a tender point at the limited area of the sacrum, the coccyx or levator muscle that is considered so called trigger point of the disease. Almost all of the cases were much improved or cured by the injection of analgesia at the points.
The above-mentioned data suggest the etiology of the disease and make valid the publication of this paper.View full abstractDownload PDF (386K) -
T. Takeshita, S. Hori, J. Horiguchi, T. Shiratori, T. Kinoshita, P. Ch ...1987 Volume 40 Issue 4 Pages 386-389
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSIn order to study the effects of storage time and temperature on various methods of fecal occult blood testing, feces were mixed with hemolysate and then three kinds of tests were performed under various conditions.
With storage of fecal samples at room temperature, chemical slide A and slide B testing revealed weak reaction from the 2nd day, while immunological latex agglutination testing showed reaction from the 3rd day.
At 4°C, none of the testing methods revealed to any change.
At room temperature, when feces were applied directly to the slide and then stored, slide A testing showed no change whereas slide B showed a weak reaction on the 4th day, as did the latex agglutination test if feces were kept in buffer solution.
In addition, when fecal hemoglobin was quantitatively measured by latex agglutination testing at room temperature, hemoglobin concentration was lowered to 45% on the 3rd day and to 40% on the 8th day. If the fecal sample was kept in buffer solution at room temperature, the fecal hemoglobin concentration revealed no change within 3 days and became lowered to 90% on the 8th day.
In conclusion, feces should be stored in a cold place. At room temperature, fecal occult blood testing shows no change within 4 to 5 days if feces are applied to the slide or kept in buffer solution.View full abstractDownload PDF (271K) -
S. Sadahiro, M. Katagiri, K. Kubouchi, T. Omura, Y. Yamada, O. Tsumura ...1987 Volume 40 Issue 4 Pages 390-394
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSLymph node dissection was performed in nerve-preserving surgery for rectal cancer using a Cavitron Ultrasonic Surgical Aspirator (CUSA). First, the preaortic plexus, superior hypogastric plexus, and hypogastric nerves were preserved using the CUSA, and separated lymph nodes were dissected out using scissors. The preserved plexus and nerves were then removed with scissors and examined for any remaining lymph nodes. The above procedure was performed on eight patients with rectal cancer, and it was found that 9, 6, 5, 4, 2, 0, 0 and 0 lymph nodes were left, respectively. The above observations suggest that lymph node dissection by CUSA does not yield perfect results.View full abstractDownload PDF (4350K) -
K. Segawa, T. Katsumata, Y. Yamamoto, M. Igarashi, H. Okabe, H. Atari1987 Volume 40 Issue 4 Pages 395-400
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 21-year-old man admitted to Kitasato University Hospital in January 1986, complaining of abdominal pain. Barium enema study showed cobblestone appearance, and fissuring ulcer with segmental narrowing at the transverse and descending colon. Epithelioid cell granuloma was found in the biopsy specimens which were taken from the colonic lesions. An Upper gastrointestinal series showed a submucosal tumor-like lesion at the gastric antrum.
After three weeks, epigastric pain appeared on early morning. Upper gastrointestinal series showed an intramural fistulous tract from the greater curvature of the antrum to the prepylorus and the duodenal bulb. Endoscopically, the orifice of the fistula was observed on the top of a submucosal tumor-like lesion. No spithelioid cell granuloma was found in biopsy specimens from the gastric mucosa. Intramural fistulous tract of the stomach was improved after corticosteroid therapy.View full abstractDownload PDF (5878K) -
Report of a Case and Review of 137 Cases Reported in JapanS. Okabe, K. Nakajima, Y. Kaneko, K. Takemura, N. Goseki, M. Endo, K. ...1987 Volume 40 Issue 4 Pages 401-407
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe experienced a case of malignant melanoma of the anorectum and reviewed 137 cases previously reported in Japan.
A 47-year-old female was diagnosed as having this disease by cytological examination and abdomino-perineal resection (APR) was performed, followed by adjuvant immuno-chemo-endocrinotherapy (DAVP, oral BCG, interferon-β and Tamoxifen regimen). Twenty-two months after the operation, she died of multiple metastases including the cerebrum.
This disease is relatively rare and has a poor prognosis. We reviewed the clinical course of this disease and the therapy, and were able to summarize our conclusions as follows : 1) Many patients complained of symptoms such as anal bleeding for an average duration of. 11 months. 2) Of the total patients, 47 were male and 86 were female. 3) In 75 of the 135 cases (55 %), the tumor was situated in the transitional zone and 24 of the 104 cases (23 %) had multiple lesions near the transitional zone.
The most important factors in prognosis appear to be the size of the tumor, the depth of invasion and macroscopical findings.
We therefore concluded that it is desirable to discover the disease at an earlier stage, and then perform APR with bilateral groin dissection and continue appropriate adjuvant therapy.View full abstractDownload PDF (1864K) -
S. Hayashi, T. Nakamura, T. Tsuchida1987 Volume 40 Issue 4 Pages 408-413
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 22-year-old male patient visited our hospital because of diarrhea and body weight loss. He had had ulcerative colitis at the age of 18 and had been treated at another hospital. Endoscopically, the rectum was smooth with good expansion, but diffuse ulceration and inflammatory polyps were observed from the sigmoid to the transverse colon. A barium enema study also showed lead pipe figure from the sigmoid colon to half of the transverse colon. We concluded that the patient had ulcerative colitis. After two months of oral DSCG administration, the ulcerative colitis was improved. Three months later, no ulceration was observed upon colonoscopic examination. The formation of mucosal bridges and inflammatory polyps was observed, and ESR and CRP became normalized. Fourteen months after discontinuation of treatment at the patient's own wish, he was hospitalized again for mucous bloody diarrhea with fever. Barium enema study and colonoscopic examination again revealed diffuse ulceration and inflammatory polyps from the sigmoid to the transverse colon.
Although the symptoms were somewhat improved upon oral DSCG administration, subfever continued and defecation was too frequent, recessitating administration of DSCG by enema. After two months, the symptoms were greatly improved, allowing resumption of oral administration with no worsening of symptoms. Colonoscopic examination found no ulceration but only inflammatory polyps. Recently, allergy has drawn attention in the etiology of ulcerative colitis and use of medication for the suppression of allergy has been initiated. However, we have not yet encountered any report in Japan indicating that DSCG is very effective. We therefore hope that DSCG will be studied and administered in more hospitals and clinics.View full abstractDownload PDF (3940K) -
H. Suwa, T. Fukushima, A Sugita, S. Masuzawa, Y. Yamazaki, A. Kubo, M. ...1987 Volume 40 Issue 4 Pages 414-418
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 32-year-old male with ulcerative colitis complicating thrombosis of the left femoral vein was reported. He had had remitting and relapsing symptoms of ulcerative colitis and had been treated with steroids and salicylazosulfapyridine for the previous 9 years.
The patient had noted swelling of the left lower leg in November, 1984. Phlebography of the left lower limb revealed thrombosis of the left femoral vein and increased collateral veins. The results of blood coagulation tests during the presence of thrombosis were as follows : platelet count 31.7×104/μl, platelet adhesiveness 82% and platelet aggregability 84%.
Platelet count, adhesiveness and aggregability were thus increased and the blood coagulation system was moderately activated. These coagulation changes associated with ulcerative colitis persisted after the thrombotic symptoms had subsided and were possibly related to the etiology of the venous thrombosis.View full abstractDownload PDF (1495K) -
T. Yagyu, N. Kikkawa, S. Endo, T. Kawahara1987 Volume 40 Issue 4 Pages 419-422
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe patient was a 47-year-old woman complaining of bloody stool. Digital examination revealed a hard, pea-sized tumor of the rectum and two hard lesions outside the rectal wall. Laboratory examination showed no abnormalities. The amount of serotonin in the blood and excretion of 5-HIAA into the urine were within normal limits. Barium enema and colonoscopy showed a sessile yellow lesion with a smooth surface 6 cm from the anal nargin. The biopsy specimen showed the the lesion to be a carcinoid tumor. Low anterior resection was performed, because of the posibility of rnetastasis to the regional lymph nodes. The resected specimen contained a small elevated lesion measuring 8×6mm.
Although the carcinoid tumor was limited to within the submucosal layer, it showed vascular invasion, and metastases to 4 regional lymph nodes were proved.View full abstractDownload PDF (4572K) -
H. Furuya, A. Nagahama, Y. Katsuura, M. Hata, T. Nakajima, Y. Ogawa, M ...1987 Volume 40 Issue 4 Pages 423-427
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAmong patients treated at our hospital, we have encountered 5 with lipomas of the large intestine. The patients comprised one male and 4 females. The lipomas were found in the cecum in one patient, in the ascending colon in one, in the transverse colon in 2 and in the sigmoid colon in one. The diameters of these lipomas ranged from 1.0 cm to 4.5 cm, and removal was performed by surgery in 3 cases and by endoscopic polypectomy in 2.
In this report, we compiled 154 cases that have been reported in Japan and discussed the characteristics of this tumor and the problems involved in its treatment.View full abstractDownload PDF (1707K) -
M. Hayashi, A. Onitsuka, S. Senga, H. Mimoto, A. Hino, Y. Ozeki, M. Hi ...1987 Volume 40 Issue 4 Pages 428-432
Published: 1987
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSeven patients with synchronous liver metastases from colo-rectal carcinoma have undergone simultaneous resection at our department since June, 1985. The patients included 5 males and 2 females with an average age of 53 years (41-67 years). All the cases of liver metastases occupied the right lobe and were solitary. Three partial resections and one subseqmentectomy of the anterior segment, two lobectomies of the right lobe and one partial resection of the posterior segment were performed. The mean blood loss was 1, 767ml (830-2, 300ml) and the mean operative duration was 6 h, 14 min (4 h, 15 min -7 h, 20 min).
There were no operathve deaths and postoperative disorders of liver function were negligible in all cases. Complication such as ileus developed in only one case (14.3%).View full abstractDownload PDF (286K) -
James C. Thompson1987 Volume 40 Issue 4 Pages 433
Published: 1987
Released on J-STAGE: June 05, 2009
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[in Japanese]1987 Volume 40 Issue 4 Pages 434
Published: 1987
Released on J-STAGE: June 05, 2009
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[in Japanese]1987 Volume 40 Issue 4 Pages 434a-435
Published: 1987
Released on J-STAGE: June 05, 2009
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[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1987 Volume 40 Issue 4 Pages 435-441
Published: 1987
Released on J-STAGE: June 05, 2009
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1987 Volume 40 Issue 4 Pages 441
Published: 1987
Released on J-STAGE: June 05, 2009
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1987 Volume 40 Issue 4 Pages 441a-442
Published: 1987
Released on J-STAGE: June 05, 2009
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1987 Volume 40 Issue 4 Pages 442-443
Published: 1987
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1987 Volume 40 Issue 4 Pages 443-444
Published: 1987
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1987 Volume 40 Issue 4 Pages 444
Published: 1987
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1987 Volume 40 Issue 4 Pages 444a-445
Published: 1987
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1987 Volume 40 Issue 4 Pages 445-446
Published: 1987
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1987 Volume 40 Issue 4 Pages 446-471
Published: 1987
Released on J-STAGE: June 05, 2009
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1987 Volume 40 Issue 4 Pages 472-485
Published: 1987
Released on J-STAGE: June 05, 2009
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