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Volume 42, Issue 3
Displaying 1-24 of 24 articles from this issue
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N. Tsurui, M. Chiba, M. Iizuka, Y. Horie, K. Igarashi, K. Kodama, O. M ...1989 Volume 42 Issue 3 Pages 321-326
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSThe results of medical treatment of 9 patients with severe ulcerative colitis are reported ; 5 patients obtained remission with medical therapy, while 4 needed surgical intervention. One patient died after a second operation. Two of the 5 patients who obtained remission with medical treatment did not respond to the initial dose of prednisolone (30 mg/day), but did respond to increased dosages (49-60 mg/day). Another patient obtained remission with prednisolone given intravenously (60 mg) and intraarterially (40 mg). Indications for surgical treatment in the other 4 cases were as follows ; 1) two patients did not respond to medical treatment, 2) a third patient had chronic persistent colitis and underwent surgery without active medical treatment, and 3) the fourth patient had associated cecal perforation. The present regimen used for treatment of severe ulcerative colitis in our department is as follows ; prednisolone 60 mg or more (i. v. or p. o.) followed by prednisolone 40 mg (i. a.). If colitis does not subside as a result of these treatments, then surgical intervention is carried out without delay.View full abstractDownload PDF (5436K) -
Discrepancy between Clinical and Morphological ImprovementsM Iizuka, M Chiba, K Igarashi, K Kodama, Y Horie, O Masamune1989 Volume 42 Issue 3 Pages 327-333
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSFive patients with Crohn's disease were treated with ED (2, 400-2, 700 kcal/day). As two patients were treated with this regimen twice, ED was evaluated in terms of its effect on seven cases both clinically and morphologically. The following results were obtained.
1) The Crohn's disease activity index (CDAI) decreased to less than 150 in all seven cases.
2) Based on the definition set by the Research Committee for Inflammatory Intestinal Disorder, Ministry, of Welfare excellent and moderate improvements were obtained clinically in 3 and 4 cases respectively.
3) Morphological improvements in colonic lesions were as follows ; a) excellent in 2 cases and moderate in one case among 3 cases showing excellent improvement clinically, b) moderate in 2 cases, slight in 1 case, and not recognized in 1 case among 4 cases showing moderate improvement clinically.
These results clearly demonstrated that clinically favorable effects did not always accompany morphological improvements.
Therefore, it is important to consider that discrepancy does occur occasionally between the clinical effect and morphological effect in cases of Crohn's disease treated by ED.View full abstractDownload PDF (6059K) -
A Iso, T Urakawa, T Yamaguchi, M Nakamoto, T Noshi, H Idei, Y Nishio, ...1989 Volume 42 Issue 3 Pages 334-340
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSOf 339 patients who underwent surgery for colorectal carcinoma during the past 17 years, 27 (8.0%) had multiple lesions. The multiple growth was synchronous in 20 (5.9%) and metachronous in 7 (2.1%). The average interval of the metachronous occurrences was 54 months. The average ages of the patients were 64.2 and 50.4 years at surgery for the synchronous and first metachronous lesions, respectively. Synchronous lesions frequently occurred in the distal large bowel, and multiple lesions were often found in close proximity to each other. Histologically, the tumors were diagnosed as more advanced than the pm stage, in 75.0% and 85.7% of first synchronous and metachronous lesions, respectively. However 65.0% of second synchronous lesions showed a degree of penetration less than that defined as pm. Curative surgery was successfully performed in 60.0% of synchronous cases, among which 5-year survival rate of 57.1% was achieved. With the metachronous cases, the first lesion was successfully eradicated in 71.4%, and the 5-year survival rate was 100%. Thus, the importance of accurate preoperative diagnosis and periodic follow-up examination was suggested.View full abstractDownload PDF (1153K) -
N Oda, H Sarashina, N Saitoh, M Nunomura, S Taniyama, M Yokoyama, I In ...1989 Volume 42 Issue 3 Pages 341-345
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSWe evaluated 49 cases of colorectal cancer accompanied by cancers of other organs. The incidence was 7.9% among all surgically treated cases of colorectal cancer at our clinic. The ratio of males to females was 1.7 to 1. The age at which colorectal cancer was detected was 61.4 years on average. An increased incidence of cancers in the right-sided colon or early stage was noted in comparison with single colorectal cancers. The affected organs frequently accompanying colorectal cancer were the stomach, uterus, prostate and head and neck, except for the thyroid gland. More than half of the patients had cancers in the digestive system. In order to improve the prognosis of colorectal cancers accompanied by cancers of other orgns, it is important to examine other parts of the alimentary tract carefully if cancer is found in the large intestine.View full abstractDownload PDF (767K) -
-Augmentation of Natural Killer (NK) Activity and Comparison with Oral Administration of IND-I Yamashita, K Tazawa, T Kasagi, S Ishizawa, K Masuyama, K Yamamoto, H ...1989 Volume 42 Issue 3 Pages 346-351
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSThe effects of intrarectal or oral administration of indomethacin (IND) were evaluated by determining NK activity of the spleen, peritoneal exudate cells (PEC) and mesenteric lymph-node cells (MLN) in non-cancerous animals and by the appearance of AOM-induced colon tumors. Non-cancerous, 5-week-old male Donryu rats were divided into 3 groups. The first group was administered 3mg of IND/kg/rat orally. The second group was administered the same dosage of IND intrarectally and the third was administered physiological saline intrarectally. One dosage each was given on the first day and 4th day - two times in all. On the 7th day, effector cells of the spleen, PEC and MLN were removed from each rat and NK activity was determined at E/T=50 against YAC-1 cells. NK activities of the spleen were 22.7%, 36.2% and 14.1% respectively, the values for the intrarectal group being 1.6-2.6 times higher than those of the other two groups. Similarly, NK activities of PEC were 35.4%, 60.2% and 16.0%, while those of MLN were 6.2%, 10.4% and 5.6%, respectively. The values for the intrarectal group were 1.6-3.8 times higher than those of the other two groups. Also, using the same three groups, the inhibitory effects of IND on AOM-induced colon tumors were evaluated. The drugs were administered twice a week for 30 consecutive weeks - 60 times in all. The average numbers of induced colon tumors per rat were 3.0, 1.4 and 5.2, showing significant inhibition in the intrarectal groups (P<0.01). These results suggest that intrarectal administration of IND is effective for inhibiting the occurrence of AOM-induced colon tumors.View full abstractDownload PDF (989K) -
K Tsujita, N Washizawa, Y Torikoshi, H Ohoke, Y Nagasawa, K Kobayashi, ...1989 Volume 42 Issue 3 Pages 352-358
Published: May 25, 1989
Released on J-STAGE: May 07, 2010
JOURNAL FREE ACCESSEndoscopic findings of colorectal submucosal tumors were studied in sixteen lesions of twelve cases we experienced.
The cases were carcinoid, leiomyoma, benign lymphoid polyp, angiolipoma, lymphangioma and hemangioma.
A diagnosis of submucosal tumor was relatively easy to make among these cases, excluding one small lesion 0.3mm in longest diameter and two nodular lesions because most of them were non-pedunculated and covered with smooth, normal mucosa.
One of the four hemangiomas was bluish and two were dark reddish. One case of carcinoid was yellowish.
Lymphangiomas were slightly grayish, glossy and transparent. They were compressible on pressure with a washing tube and the shape of the larger lesions varied with a change in position.
Carcinoid felt the hardest among the solid submucosal tumors.
Benign lymphoid polyp, leiomyoma and angiolipoma seemed to have few characteristic featues that could distinguish them by endoscopic examination.
Not only gross observation but also palpation with biopsy forceps or a washing tube was thought to be useful for the qualitative diagnosis of submucosal tumors.View full abstractDownload PDF (5728K) -
I Hirai1989 Volume 42 Issue 3 Pages 359-363
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSSince the introduction of the hemoligator to Japan, its application for the treatment of hemorrhoids has become widespread. Its popularity is due to characteristics such as 1) no necessity for anesthesia 2) utility in an outpatient clinic 3) the simple and nonsurgical procedure involved and 4) no risk of anal stenosis. However, this method has certain drawbacks such as possible swelling of external hemorrhoids, bleeding or recurrence caused by premature dehiscence and its indication for only 2nd or 3rd degree hemorrhoids. For these reasons, full clinical application has been limited.
To broaden the method's applications, I examired its characteristic ability to collect hemorrhoidal and surrounding tissue into the drum. Practically, my method consists of fixation of the ligated hemorrhoid with an additional suture. This approach has been applied to cases so far consideced unsuitable with good results.View full abstractDownload PDF (750K) -
H Nakayama, H Sarashina, N Saito, M Nunomura, T Arai, S Taniyama, M Yo ...1989 Volume 42 Issue 3 Pages 364-370
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSA total of 169 colorectal polyps treated in our department during the past 5 years were surveyed. We studied the presence of CEA and CA 19-9 in 30 colonic adenomas containing focal carcinomatous glands by the PAP method and mucin alterations in all specimens using HID-AB and PAS straining. Adenomatous glands were divided into those with mild, moderate, and severe dysplasia and carcinoma. Based on the distribution patterns of CEA, localization was graded from Grade 0 to 3. Thereafter, the correlation between the histologic manifestations and the grade of CEA localization was assessed. As a result, 96 % of our cases were stained positively for CEA, whereas only 47% were positive for CA 19-9. Seventy percent had an area of more than two-thirds showing a positive CEA reaction, whereas in contrast, only 7 % showed two-thirds staining for CA 19-9. CEA showed a uniform distribution, but CA 19-9 exhibited focal or spotted staining. In general, CEA localization tended to demonstrate higher grades of reactivity with the progress of atypia. However, it was impossible to discriminate the degree of atypia, particularly between severely dysplastic glands and carcinomatous glands. It was also noted that CA 19-9 localization was not related to dysplastic changes seen in adenomas. Mucus secretion was reduced with the advance of atypia, finally resulting in almost complete depletion in carcinomatous glands. Adenomatous glands rather randomly showed sialomucin-dominant, sulfomucin-dominant or mixed patterns independent of any correlation with the degree of atypia.View full abstractDownload PDF (9723K) -
N Oshitani, A Kitano, H Okabe, R Fukushima, K Kashima, S Nakamura, A O ...1989 Volume 42 Issue 3 Pages 371-376
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSTwenty-three patients with severe ulcerative colitis who were admitted to our hospital between Jan. 1983 and Apr. 1988 were studied. The clinical type was a first attack in 5 patients, relapsing type in 17 patients, and chronic type in one patient. There were 12 cases of total colitis and 11 of left-sided colitis. One patient with proctitis developed total colitis, and another patient with proctitis developed left-sided colitis. Two patients with left-sided colitis developed total colitis. In the acute stage, response to medication took a significantly longer time in patients with total colitis or when there was inflammatory polyposis. Six patients were treated surgically. In these patients, expansion of the disease was significantly more common.View full abstractDownload PDF (931K) -
K Fukushima, A Yagita, H Matsumoto, H Ito, I Tatekawa1989 Volume 42 Issue 3 Pages 377-383
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSHLA antigens were measured in 272 cases of single colon cancer and in 30 cases of triplicate and duplicate colon cancer, and were compared with those in 310 control cases. Among HLA antigens, Cw3 and B 35 were found at significantly high incidence in single colon cancer, and Cw 3 and DQw 3 occurred frequently in triplicate and duplicate colon cancer (corrected p<0.05), while the incidence of DRw 52 was significantly low in single colon cancer, and that of DQw 1 was significantly low in triplicate and duplicate cancer (corrected p<0.05). An HLA antigen common to both single and triplicate and duplicate colon cancers at a significant level was Cw 3. Since the incidence of this antigen was high as 90 % in cases of triplicate and duplicate colon cancer, in which genetic factors are thought to be strongly involved, showing a relative significance level of 10.5, it was suggested that genetic factors, especially Cw 3 antigen, play an important role in the etiology of colon cancer. In this study, it was also suggested that the etiology of colon cancer is colosely related to the immune response of the host as well as immunosuppression, because incidences of a number of antigens (DRw 52, DQw 1 and DQw 3) in the HLA-class II antigen system, which control individual differences in immune response, differed significantly between cancers. Thus, we strongly felt that determination of HLA antigens was important in cases of malignant tumor.View full abstractDownload PDF (1027K) -
Y Horita, S Okumoto, K Kuroda, M Katoh, Y Saitoh1989 Volume 42 Issue 3 Pages 384-390
Published: May 25, 1989
Released on J-STAGE: February 05, 2010
JOURNAL FREE ACCESSOne hundred and thirty-seven patients who had undergone colostomy and ileostomy were studied in order to determine the incidence of early complications and the factors causing them.
The most common complication was skin irritation (37.1 %). The incidences of retraction, necrosis, stenosis, fistula formation and infection of the wound were less than 10 %. Skin irritation and infection were decreased significantly after the use of a skin barrier, but retraction, necrosis, stenosis or fistula formation showed no such decrease.
Primary opening of the stoma decreased the incidence of skin irritation and stenosis, and infection was not increased. Therefore, primary opening of the stoma was thought to be a useful technique. Among patients who underwent stoma1 reconstruction, the incidences of necrosis, fistula formation and skin irritation were significantly higher than in primary cases.
On the other hand, the majority of cases with duplicated complications had retraction, necrosis, stenosis and fistula formation, and usually had accompanying skin irritation. Moreover among these cases, post-reconstructive cases or cases requiring surgery because of such complications were significantly frequent.View full abstractDownload PDF (1205K) -
K Nakamura1989 Volume 42 Issue 3 Pages 391-398
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSRadioimmunoassay (RIA) and enzymeimmunoassay (ETA) are presently employed for measurement of blood CEA level, and each of them has several kinds of techniques and methods.
In order to confirm whether or not blood CEA values obtained from colorectal cancer patients using these different techniques or measuring kits are equally reliable, blood CEA values were simultaneously measured with generally used RIA and ETA, CEA-RIA (Z-Gel) kit (Roche) and CEA-ETA kit (Abbott) on each of colorectal cancer patients.
Results
1) There was a good correlation between preoperative CEA values in colorectal cancer patients using ETA and those with RIA.
2) ETA showed lower false-negative rates and higher positive rates for relatively early stages of cancer than RIA.
3) In patients with mucinous carcinoma, poorly differentiated adenocarcinoma, carcinoma of the colon which metastasized to the liver or who showed more than 60 ng/ml, the values of each method tended to be different, probably due to the inequality of the composition of CEA and the difference in activity of each anti-CEA antibody. However, the discordances were observed in very few cases whose levels were around 5 ng/ml, which was very important for judging whether normal or not. Moreover, they had no problem to detect the recurrent cases.
ETA was more convenient for practice, because it required no radioisotope (RI) and achieved a same diagnostic values.View full abstractDownload PDF (1327K) -
-Report of a Case and Review of the Japanese Literature-K Funahashi, K Watanabe, T Kuwahara, K Kobayashi, K Yanagita, T Yoshio ...1989 Volume 42 Issue 3 Pages 399-405
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSA case of lymphangioma of the transverse colon in a 30-year-old woman is reported, together with a review of 47 other cases reported in the Japanese literature. The patient visited our department because of lower abdominal pain, but appeared well and laboratory data were normal. Abdominal ultrasonography, computed tomography and barium enema revealed a cystic tumor in the transverse colon. Colon fiberscopic examination showed a soft and smooth-surfaced Yamada Ill-type tumor located about 90cm oral to the anus. The diagnosis of cystic lymphansgioma of the transverse colon was confirmed preoperatively. Because of obstructive symptoms, emergency partial colectomy was performed and the resected tumor measured 3.3× 2.4cm. The tumor was fillled with clear yellow serous fluid, and histologically, it was a cystic lymphangioma arising from the submucosal layer. In a review of the Japanese literaturese, we found reports of successful endoscopic polypectomy for small lymphangiomas : all were less than 2.0 cm in diameter. However we consider that a tumor larger than 2.0 cm could be resected by endoscopic polypectomy following diameter reduction by puncture.View full abstractDownload PDF (3350K) -
S Kamiya, H Shida, T Yamamoto, [in Japanese]1989 Volume 42 Issue 3 Pages 406-410
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSA case of melanoma in the ascending colon metastatic from the right sole is reported.
The patient was a 69-year-old woman, who had undergone resection of malignant melanoma on her right sole with right inguinal lymph node dissection in January 1983. Many lymph node metastases were confirmed histologically. In February 1985, she was readmitted to our institution because of nausea, vomiting and loss of body weight. A fist-sized mass was palpable in the right lower quadrant of the abdomen, Barium enema and total colonoscopy showed a dark protruding tumor of Borrman type-1 in the ascending colon. The tumor was diagnosed as malignant melanoma histologically. Right hemicolectomy was performed and her symptoms improved. However, she died of systemic metastasis of the melanoma eight months after the operation.
This case was considered noteworthy because melanoma of the sole rarely metastaises to the colon.View full abstractDownload PDF (4845K) -
N Kano, N Yamada, T Adachi, Y Haeno, E Wada, K Inada, E Matsunami, H S ...1989 Volume 42 Issue 3 Pages 411-414
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSA case, of cecal cancer with metastasis to the uterus is reported.
A 41-year-old woman complaining of lumbago and lower abdominal pain of two months' duration visited a hospital and abnormal findings in the ileocecal region were noted. She also visited the gynecology department of our hospital and a diagnosis of adenocarcinoma of the uterine cervix was obtained. Laparotomy visualized a goose-egg-sized tumor in the ileocecal region. Dissemination to the adjacent mesentery and extensive lymph node metastasis with lymph congestion in the mesentery and around the aorta were also identified. A diagnosis of ileocecal cancer with metastasis to the cervix, or double cancer was made. Right hemicolectomy and panhysterectomy with associated resection of both adnexa were performed. Histopathological examination confirmed the diagnosis of cecal carcinoma with metastasis to cervix.
It is believed that this carcinoma had metastasized to the cervix by retrograde lymphatic spread subsequent to tumor obstruction of the retroperitoneal lymphatics.View full abstractDownload PDF (5882K) -
S Ohhigashi, Y Ohtani, H Katoh, K Umeda, M Mori, N Matsumoto, H Azuhat ...1989 Volume 42 Issue 3 Pages 415-419
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSA case of colon cancer with intra-abdominal abscess in a young patient is reported. A 24-year-old male was admitted to our hospital with chief complaints of abdominal pain, diarrhea and fever. Since localized peritonitis was observed in the right lower abdomen and ultrasonography revealed intraabdominal abscess, an emergency operation was performed. The greater omentum formed the abscess walls which adhered tightly to the transverse colon. This was diagnosed as colon cancer after resection of the abscess and partial colectomy and, therefore, right hemicolectomy was performed. Histopathologically, the lesion was classified as moderately differentiated adenocarcinoma, but both poorly differentiated adenocarcioma and mucinous adenocarcinoma were also observed partially. According to stage classification, the lesion was ss, a2, n (-), H0, P0, stage II. In general, colon cancer in young patients shows a high degree of biological malignancy with a poor prognosis. Early diagnosis is of primary importance for the improvement of prognosis. Therefore, the possibility of cancer should be always taken into account regardless of patient age.View full abstractDownload PDF (3231K) -
N Maruyama, Y Naritaka, T Hosokawa, T Ogawa, S Ishikawa, Y Ohtani, T K ...1989 Volume 42 Issue 3 Pages 420-424
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
JOURNAL FREE ACCESSCases of endometriosis occurring in the intestinal tract and inducing ileus have been reported only rarely in Japan. A recent case of ileus subsequent to endometriosis in the sigmoid colon is reported in this paper. The patient was a 29-fear-old married woman complaining of abdominal pain. She had a history of ovariectomy for left ovarian cystoma at the age of 22 years. When she was 25 years old, she had undergone surgical opening of an obstructed right uterine tube. She had visited a negihborhood doctor on April 7, 1988, because of abdominal pain. She underwent proctostomy because the condition subsequently became aggravated to ileus. The patient was admitted to our department on April 16 for re-operation. Contrast enema and colorectal endoscopy revealed complete obstruction at a site 20 cm from the anal verge. Laparotomy was performed under a suspicion of malignant tumor or endometriosis in the intestinal tract. Since a perioperative pathological diagnosis of sigmoid colon endometriosis was obained, sigmoidectomy was carried out.View full abstractDownload PDF (5165K) -
[in Japanese]1989 Volume 42 Issue 3 Pages 425
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
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[in Japanese]1989 Volume 42 Issue 3 Pages 425a
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
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[in Japanese]1989 Volume 42 Issue 3 Pages 426-430
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
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1989 Volume 42 Issue 3 Pages 430-433
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
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1989 Volume 42 Issue 3 Pages 433-435
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
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1989 Volume 42 Issue 3 Pages 435-456
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
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1989 Volume 42 Issue 3 Pages 457-483
Published: May 25, 1989
Released on J-STAGE: October 16, 2009
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