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Volume 46, Issue 1
Displaying 1-18 of 18 articles from this issue
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K. Funahashi1993 Volume 46 Issue 1 Pages 1-9
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe studied immunohistochemically ras oncogene products (ras p 21) expression in 120 colorectal cancers. Positive staining of ras p 21 was detected in 63 (52.5 %) of 120 colorectal cancers. Positive staining of ras p 21 was more frequently detected in advanced stage, namely the incidence of positive staining for ras p 21 was significantly higher in cases with invasion of depth of ss (a1) or beyond ss (a1), lymphatic vessel invasion and lymph node metastasis.
There was no relationship between the incidence of ras p21 expression and DNA ploidy pattern or DNA index.
The prognosis of colorectal cancers showing negative ras p 21 was significantly better than that of cancers showing positive ras p 21 (p<0.05). PCNA labeling index and Ag-NORs dot number in ras p 21 positive area of cancer tissues were significantly higher than those in ras p 21 negative area.
Therefore we supposed that the proliferative activity in ras p 21 positive carcinoma was higher than in ras p 21 negative one.
These results suggested that ras oncogene expression related to the progression and to the prognosis of colorectal cancer.View full abstractDownload PDF (2547K) -
T. Sameshima1993 Volume 46 Issue 1 Pages 10-19
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThree types of operative procedures on pelvic autonomic nerves, i. e., bilateral-preserving, unilateral-preserving and bilateral-cutting, were applied to 26 patients with rectal cancer and 58 adult mongrel dogs. The postoperative bladder function was assessed by the degree of dysfunction determined by the results of urodynamic study. The morphological changes of urinary bladder in rectal cancer patients were studied on the findings of retrograde cystogram taken 6 months after operation. Those in dogs were done on the resected specimens.
The changes in postoperative vesical function occurred very similarly in patients and dogs. The function was well preserved, and no significant changes occurred after bilateralpreserving operation. The function was disturbed in early postoperative period, but recovered thereafter following unilateral-preserving operation. On the contrary, significant changes occurred and lasted to the end of observation period after bilateral-cutting operation. The postoperative cystogram showed the findings of widening of internal orifice and irregularity of vesical wall most remarkably in patidnts after bilateral- cutting operation. The findings were less remarkable after unilateral-preserving operation. These morphological changes were related to the occurrence of functional disorders. After bilateral-cutting operation, thickening and inflammatory changes in vesical wall of dogs were also observed most remarkably, and became prominent with the lapse of time. The morphological changes occurred probably following denervation of urinary bladder and subsequent functional disorders.
The unilateral-preserving operation was considered to be worthy of clinical application from the viewpoint of postoperative preservation of urinary bladder function.View full abstractDownload PDF (2110K) -
A. Koide1993 Volume 46 Issue 1 Pages 20-26
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe overexpression of p53 was determined immunohistochemically, using an avidinbiotin peroxidase method with anti p53 mouse monoclonal antibody (PAb-1801), in 81 carcinomas, 36 adenomas, and 42 normal mucosae of the colorectum.
Intense immunoreactivity for p53 was detected in 44 carcinomas (54.3 %), in 4 adenomas (11.1 %), while no staining for p53 was demonstrated in normal mucosae.
The overexpression of p53 was significantly more often detected in carcinomas than in adenomas (p<0.01) and normal mucosae (p<0.01), and it was significantly more often detected in adenomas than normal mucosae (p<0.05).
There was no correlation between the overexpression of p53 and clinicopathlogical variables except liver metastasis (p<0.05). The immunoreactivity for p53 did not correlate with DNA aneuploidy of colorectal carcinomas. These results sugget that p53 is implicated in the late step in colorectal tumorigenesis, but is not implicated in the progression of overt colorectal carcinomas.View full abstractDownload PDF (2211K) -
K. Okabe, E. Ikeda, T. Satoh, A. Kikuchi, Y. Ohta1993 Volume 46 Issue 1 Pages 27-33
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSCEA levels in gallbladder (GB) bile obtained from 64 patients with colorectal cancer were determined so that the diagnostic value of them can be evaluated. The levels were significantly high in the patients with liver metastases as compared to those involved no liver lesion (H0) or normal control subjects. There was, also, a close correlation between CEA levels in GB bile and the tumor volume of liver metastases. So far as the H0 patients were concerned, the increase in CEA levels in GB bile was attributable to either regional lymphnode metastasis or serum CEA levels. In conclusion, GB bile has more accurate diagnostic property than sera, for CEA from liver metastases is excreted in the bile. However, further clinical study is necessary to elucidate a role of GB bile in early detection of the hepatic recurrence after surgery for colorectal cancer.View full abstractDownload PDF (467K) -
R. Arima, N. Kikkawa, Y. Tamaki, T. Yagyuu1993 Volume 46 Issue 1 Pages 34-39
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSHistopathological factors that influence the prognosis of stage II carcinoma of colon and rectum were studied using 50 surgical materials, all cases of which had been appeared to be curably operated.
They were divided into two groups. The group A, included worse prognostic 25 cases with local recurrence and/or distant metastasis. The group B included better prognostic 25 cases without any recurrence and/or metastasis for 5 years after surgical treatment. The comparative study between A and B groups was made about degree of main histological differentiation of carcinoma, hisological dedifferentiating features at the edge of invasion of subserosa and serosa, infiltrative mode, depth of invasion and both lymphatic and venous vascular invasion.
The results are as followings.
As to main histological differentiation, well differentiated adenocarcinoma (well) acco-unted for llcases, moderately differentiated adenocarcinoma (mod) for 11 and mucinous carcino-ma (muc) for 3 in group A. In group B, well accounted for 16, mod for 7 and muc for 2. Group A revealed the dedifferentiated feature at the edge of invasion of subserosa and serosa more clearly in contrast to group B. Concerning infiltrative mode (inf), expansive growth (a) accounted for 8 and expansive and infiltrative growth (β) for 17 in group A. In group B, a accounted for 16 and β for 9.
The depth of invasion was ss (a1) in 9 and s (a2) in 16 in group A and ss (a1) in 21 and s (a2) in 4 in group B. The incidence of venous invasion was 96% in group A and 64% of group B. The incidence of lymphatic vessel invasion showed no significant difference between them.
The results suggest that degree of main histological differentiation, at the invasive borders, infiltrative mode, depth of invasion and venous invasion are important histopathological factors to predict the prognosis of stage II carcinoma of the colon and rectum.View full abstractDownload PDF (2922K) -
K. Kobayashi, T. Katsumata, M. Igarashi, K. Saigenji, Y. Otani1993 Volume 46 Issue 1 Pages 40-47
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe compared the pre-operative quality of life in patients with Crohn's disease who eventually underwent surgery (17cases) with patients who did not undergo surgery over average follow-up period of more than 3 years (19 cases). And we also studied on operative indications for Crohn's disease viewed from morphological findings. (1) In the operated cases, the average period from onset of disease to the first operations was 4.8 years. In 88% of cases, the reasons for the first operations were intestinal stenosis and internal fistula. (2)In clinical course, quality of life for the operated cases was clearly unfavorable compared to those who did not underwent surgical treatment. The average score of CDAI at admission and mean duration of admission in operated cases were relatively higher and longer than those of non-operated cases. (3)Viewed from morphological findings by radiographic examinations, there were many cases in which cobblestone appearance and intestinal stenosis with fissuring ulcers developed into intestinal stenosis and internal fistula. In such cases, it was suggested that surgical treatments would be frequently required in furture. The patients with intestinal stenosis over 3 cm in length were frequently induced obstructive symptoms. (4)Early operation was necessary for patients, whose life ability was reduced over average follow-up period of more than 30% by Crohn's disease and its complications. In such cases, morphological complication (such as intestinal stenosis and internal fistula) was also frequently observed.View full abstractDownload PDF (1996K) -
Indication of Lateral Subcutaneous Internal SphincterotomyS. Hasegawa1993 Volume 46 Issue 1 Pages 48-53
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAnal manometric studies were performed in one hundred thirty patients with anal fissure. The maximal resting pressure of anal fissure (83.5±16.0 mmHg) was significantly higher than that of sixty-one controls (56.8±11.9mmHg) (p<0.001). Fifty-seven patients whose anal resting pressure was higher than 80 mmHg or who complicated anal stenosis were indicated lateral subcutaneous internal sphincterotomy (LSIS), and pre- and postoperative manometric studies were evaluated. Postoperatively, the maximal resting pressure was significantly decreased (p<0.001). Fifty-four out of 57 patients healed well, however, three patients whose maximal resting pressure was not lowered, did not heal and required reoperation. Among eighteen conservatively treated patients whose maximal resting pressure were higher than 80 mmHg, only four (22%) healed. Subsequently, the patient with anal fissure whose maximal resting pressure was higher than 80 mmHg would be treated surgically and less than 80 mmHg would be treated conservatively. Anal manometry is quite useful for deciding the operative indication and postoperative follow up.View full abstractDownload PDF (365K) -
A. Kubo, M. Kin, K. Kameda1993 Volume 46 Issue 1 Pages 54-57
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA case of solitary metastatic sigmoid colon cancer from ovarian cancer was reported. A 57-year-old woman was admitted to our hospital complaining of the left lower abdominal tumor. She had had an extended hysterectomy for ovarian cancer 5 years and 7 months before. Findings of ultrasonographic examination and computed tomography indicated that the tumor was recurrence of ovarian cancer. She underwent a laparotomy and the tumor was diagnosed as metastatic sigmoid colon cancer. Sigmoidectomy with lymph node dissection was performed, Histopathological findings revealed metastasis of cystadeno-carcinoma from ovarian cancer. Cancer chemotherapy using doxorubicin, cyclophosphamide and cisplatin was given postoperatively. She has been doing well for 6 months post-operatively.View full abstractDownload PDF (2653K) -
M. Horiguchi, M. Iwabuchi1993 Volume 46 Issue 1 Pages 58-64
Published: 1993
Released on J-STAGE: December 03, 2009
JOURNAL FREE ACCESSThe case was a 45-year-old schizophrenic woman on longterm psychotropic drug treatment who was frequently constipated and in the habit of taking laxatives. The chief complaints were abdominal pain and distention. Thanks to psychotropic drugs, the usual signs of perforation of the colon were scarce, but she presented fever, abdominal distention, and mild tenderness and defense in the left middle and lower abdomen. X-rays showed free air below the diaphragm, pneumoretroperitoneum and a fecal mass. Leukocytosis was present. From these findings, peritonitis due to colonic perforation was diagnosed. Emergent operation was performed : as the sigmoid colon was perforated and a hard fecal mass on its oral side extended to the descending colon, left hemicolectomy inclusive of the fecal mass was done with one-stage operation using EEA and internal sphincterotomy. Inspection and histological survevy of the resected aterial revealed five ULI-II ulcers, resulting from impacted fecal mass, at the site of sigmoid perforation and in its neighborood. We report a schizophrenic patient with sigmoid perforation due to impacted feces that was cured by surgery, with discussion of the documented cases in Japan.View full abstractDownload PDF (4348K) -
H. Masuda, S. Hayashi, Y. Nakamura, H. Horiuchi, K. Watanabe, I. Hayas ...1993 Volume 46 Issue 1 Pages 65-68
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSPuborectalis syndrome was first reported by Wasserman in 1963 who described it to be rectal stenosis due to hypertrophy of the puborectal muscle and anorectal spasm. We experienced a 39-year-old man with puborectalis syndrome who had been constipated and had anal pain. Findings from a barium enema could not deny rectal cancer completely. He underwent myotomy and his postoperative course was very good. Follow-up was carried out for 9 months; however, long-term follow-up is needed because a suitable therapy has not been completed.View full abstractDownload PDF (1189K) -
H. Tomochika, K. Kawakami, T. Yamamoto, Y. Matsuda1993 Volume 46 Issue 1 Pages 69-72
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 56-year-old woman was admitted to our hospital with a history of right hypochond-ralgia. Physical examination was unremarkable. Barium enema and colonoscopy revealed a hen's egg sized polypoid lesion with a soft and smooth surface in the right transverse colon. The tumor moved freely and showed fatty tissue density at abdominal computed tomography. It was diagnosed as a pedunculated lipoma. Endoscopic polypectomy was unsuccessful because the tumor was too large for safe snaring. A segmental resection was done. The pathologic diagnosis was submucosal lipoma of the transverse colon.View full abstractDownload PDF (2555K) -
H. Ikuta, S. Naitoh, T. Sako, S. Matsumoto, F. Kurogo, T. Akematsu1993 Volume 46 Issue 1 Pages 73-77
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThis paper describes our recent expertence with a case of a retrograde intussusception due to a sigmoid polypiform cancer in the light of the related literature. The patient was a 66-year-old man who was admitted to our hospital due to lower abdominal pain. Abdominal X-ray showed a ileus shadow of large intestine. X-ray computed tomography showed the intestine and the mesenterium-like composition in transverse and descending colon. Therefore we diagnosed a intussusception of colon and mechanical ileus, and laparotomy was immediately performed. The sigmoid colon invaginated into the descending and transverse colon retrogradely, we could not rule out the existense of malignant tumor, so the colon, from the left transverse colon to thm upper half of the sigmoid colon, was resected with regional lymphnodes. The resected specimen showed a small polyp (11×10mm) at the top of the intussusceptum. Microscopic examination clarified that the polyp was a well differenciated adenocarcinoma within the mucosa and lymphnode metastasis was negative.View full abstractDownload PDF (1636K) -
T. Tagawa, Y. Oota, Y. Nakano, M. Morinaga, T. Nagayasu, H. Shinguu, A ...1993 Volume 46 Issue 1 Pages 78-82
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 64-year-old male was admitted to our hospital with a diagnosis of ileus due to colon cancer. He had no colon cancer in the family history. A barium enema study showed four lesions: a large elevated mass in the Rs region, a site of severe stenosis proximal to it, a small filling defect and a more proximal site of complete obstruction in the S region with the first lesion being closest to and the last region farthest away from the anus. Colon fiberscopy showed a type 1 tumor 20cm from the anus but no further observation was possible beyond this region. High anterior resection was performed and the specimen showed synchronous quadruple cancers of the rectum and sigmoid colon. The lesions were classified macroscopically to be type 1, type 2, type I p, and type 1 with the first one closest to and the last one farthest away from the anus. Microscopically, they were all well-differentiated adenocarcinoma but were separate from each other. The depths of the tumors were pm, ss, sm and pm, which means that three were advanced and one, early cancer. Analysis of the DNA ploidy patterns of the tumor tissues showed that the lesions were probably aneuploidy, diploidy, diploidy and diploidy. No evidence which support transluminal metastasis of the four tumors was obtained in this patient. No recurrence appeared in the follow up period of 2 years and 10 months.View full abstractDownload PDF (1762K) -
T. Noritomi, K. Shirouzu, Y. Araki, T. Morodomi, H. Isomoto, T. Kakega ...1993 Volume 46 Issue 1 Pages 83-85
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 67-year-old man has suffered from erythema of the genital lesion for 4 months. He had also ascending colon cancer and a rectal cancer. The erythema of the genital resion was extramammary Paget's desease. Operations were performed for each tumors. There was no relation between the genital Paget's Disease and the multiple colon cancer. Moreover, there were no underlying carcinoma and cacinoma of adnexal structures with the genital Paget's disease. Therefore, it was considered that the extramammary. Paget, s disease and the multiple colon cancer had occurred simultaneously.View full abstractDownload PDF (1641K) -
K. Nabeta, T. Adachi, T. Tsutsui1993 Volume 46 Issue 1 Pages 86-89
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSchwannomas of the digestive tract are very rare, especially in the colon. Recently we experienced a case of rectal schwannoma. A 76-year-old male visited our clinic with the chief complaint of constipation since about a year before. The patient was preoperatively diagnosed as having sub-mucosal tumor in the rectum by Ba-enema, colonofiberscope and CT scanning of the pelvic cavity. The tumor was excised by trans-sacral approach, and was 8.5×6.0×4.0cm in dimension with kidney-like shape. Then the tumor was pathologically diagnosed as schwannoma.
The patient is alive healthy without any evidence.View full abstractDownload PDF (2799K) -
T. Suda, K. Hatakeyama, H. Ishikawa, H. Okamoto, Y. Takii, H. Saito, C ...1993 Volume 46 Issue 1 Pages 90-95
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSClinicopathologic characteristics of 20 patients, 11 men and 9 wemen with an average age of 64.9 (35-79), with primary diffusely infiltrating carcinoma of the colon and rectum were studied. The incidence of the lesions was 0.6% (20/3633) in our series of surgically resected carcinoma of the colon and. rectum. They located in the colon in 11 patients (C : 2, A : 1, T : 2, D : 1, S : 5) and in the rectum in 9. Alteration in bowel habit and abdominal distension were the most frequent symptoms. The histlogic types of the lesions were poorly differentiated adenocarcinoma in 9, signet-ring cell carcinoma in 5, well differentiated adenocarcinoma in 3 and moderately differentiated adenocarcinoma in 3. All lesions spread beyond the proper muscle with marked lymphatic permeation. The prognosis was vevry poor ; 18 patients in the present series died of the disease. All patients with poorly differentiated or signet-ring cell carcinoma died within 1 year after surgery. These lesions were classified histologically into two types, differentiated type and undifferentiated type. This classification was useful and revealed prognostic significance and histologic characteristics of the tumor.View full abstractDownload PDF (1920K) -
K. Kunitomo, Y. Terashima, M. Horiuchi, K. Sasaki, N. Komi1993 Volume 46 Issue 1 Pages 96-99
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSTo prevent implantation metastases of rectal cancer during surgery, a new double concentric sump tube, 33 Fr. sized in diameter (Sumitomo Bakelite Co., Tokyo), was modified and introduced for intraoperative rectal irrigation on 10 patients undergone anterior resection for rectal or rectosigmoid cancer. 1000 ml of normal saline was used for intraluminal irrigation of the anal side of the rectum from tumor within 10 minutes and a cytological investigation of collected fluid was carried out to assess the effect of irrigation. As a result, 7 out of 10 patients were found to be positive cytology at the beginning, and none of the patients had tumor cells in the collected fluid at the end of irrigation. The result shows that this simple method might be useful to prevent implantation metastasis of rectal cancer during surgery.View full abstractDownload PDF (255K) -
1993 Volume 46 Issue 1 Pages 100-110
Published: 1993
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (967K)
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