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Volume 48, Issue 4
Displaying 1-13 of 13 articles from this issue
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N. Murata1995 Volume 48 Issue 4 Pages 281-288
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSTo investigate the difference of malignant potential among macroscopic types, the objective atypism and argyrophilic nucleolar organizer resions (Ag-NORs) score were measured in 134 lesions of minute colorectal epithelial neoplasms (5mm or less in diameter). Tose neoplasms were classified macrosccopically into four groups according to the classification of early gastric cancer as follows: elevated type (I s, n=34); superficial elevated type (II a, n=64); superficial elevated type with central depression (II a+II c, n= 21); and superficial depressed type (II c, n=15). The index of nucleus-gland ratio (ING) in superficial types (II a, II a+ 11 c or IIc) was significantly higher than in the is type (p<0.01). ING in the II c type was also higher than in the II a and the II a+II c type (p<0.05). On the other hand, the index of structural atypism (ISA) in the IIc type was singnificantly lower than in the I s type (p<0.05). Ag-NORs score in the lower half of the mucosa in superficial types (II a, II a+II c or II c) was significantly higher than in the I s type (p<0.05, p<0.01, p<0.01), and tended to be higher in the II a+II c and the II c types than in the II a type. These results, excluding ISA, suggest that superficial types (II a II a+IIc or IIc) have higher malignant potential than in the I s type, and the II c type has the greatest malignant potential of minute colorectal epithelial neoplasms.View full abstractDownload PDF (3281K) -
I. Kawa1995 Volume 48 Issue 4 Pages 289-300
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe recenty developed a unique, simple apparatus for synchronizing manometry and defecography, which has been used to investigate patients who have defecation disorders, and have compared them with normal subjects. Studies were performed on 15 normal subjects and 55 patients who complained of suffering from defecation disorders such as constipation, incontinence, perineal discomfort, anal pain, a sensation of incomplete evacuation, and straining. The patients were classified into 4 groups: a constipated group without rectocele (group 1), a constipated group with rectocele (group 2), a group composed of other symptoms with rectocele but not constipated (group 3), and an incontinence group (group 4). Measurements were taken for the anorectal angle (ARA), perineal desemt (D), the ratio of the maximun crossed section area of the rectum (S 1) to the anal canal(S 2) : S2 / S1, rectal pressure and anal canal pressure at rest, squeeze, astrain, anorectal pressure difference at strain (ARPD) and a new index calculated as ARPD × (S2 / S1). This index can be interpreted as anorectal evacuability. There was a signifi-cant relationship in ARPD × (S2 / S1) between groups 1, 2 and 3 and the control group, and between groups 2 and 3.In constipated patients, the anorectal evacubility was significantly less than in others.View full abstractDownload PDF (3176K) -
M. Sato, H. Ohta, M. Ueno, M. Seki, Y. Okada, M. Kinoshita, H Yamada, ...1995 Volume 48 Issue 4 Pages 301-306
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSTo clarify the pathological chalacteristics of peritoneal dissemination in colorectal cancer, the differentiation of the primary and disseminated metastatic lesion was examined pathologically. A clinicopathological study was carried out on 16 cases of primary colorectal cancer with pertoneal dissemination which was resected in a relatively noncurative manner, and the following results were obtained.
1. In peritoneal disseminated cases, well-differentiated adenocarcinoma on the mucosal side was less differentiated infiltrated and scattered on the serosal side. In cases other than well-differentiated adenocarcinoma, the pathological type on the serosal side was the same as that on the mucosal side.
2. In peritoneal dissemination, the pathological type is almost the same as that on the serosal side.
3. In cases without peritoneal dissemination penetrating to the serosa, the patholo-gical type on the mucosal side was generally well-differentiated adenocarcinoma and was less differentiated on the serosal side, but infiltrated expansively.View full abstractDownload PDF (4304K) -
T. Fujiyoshi, R. Nozaki1995 Volume 48 Issue 4 Pages 307-316
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSIs it true that a colon polyp can become cancer?
Regarding the answer to this question, two different theories exist. One is that a polyp, if it remains uncured for a long time, is considered to develop into cancer. The other is that, since a polyp seems to be orginally a distinct form of cancer and not to be a precursor of cancer, it will not develop into cancer if uncured. These two theories have been vehemently. dekated for about fifteen yeas.
The objective of this research was to statistically analyze follow-up system while following up polypectomies performed ten years ago to clear up this issue. For ten years, 1038 cases of polyp could be followed up using all systems. If cases that have been followed up at least for the last five years are added there to, the number may total 2765 cases.
We investigated cancer samples among these cases and picked up factors related to the production of cancer in terms of risk. As a result, a difference of significance based on age, sex, number, type and dysplasia was validated for 10mm or larger polyps.View full abstractDownload PDF (516K) -
H. Kayaba, H. Saitoh, K. Kodama1995 Volume 48 Issue 4 Pages 317-324
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAnorectal function was evaluated in 18 patients who had spinal disease and 17 heal-thy subjects using anorectal manometry. A total of 6 of the 18 patients studied had pro-blems with defecation. Twelve of the patients had lumbar, 3 cervical, 2 thoracic and 1 sacral spinal lesions. Patients who had lumbar spinal lesion had rectosphincteric reflexes longer in duration than healthy subjects. Tow patients who had thoracic spinal lesion had rhythmic waves of subnormal frequency in the anal canal. In 3 Patients who had lumbar spinal lesion (two had burst fracture of L 1 and one had L 4-L 5 disk hernia), manometric studies were performed before and after surgery. All 3 of these patients had prolonged rectosphincteric reflexes before surgery. Duration of this reflex returned to normal in 2 patients, each of whom regained normal bowel function after surgery. One without postoperative improvement of manometric study continued to have defecational problems. Further study will be required to clarify the relationships between anorectal manometric study and site of spinal lesion.View full abstractDownload PDF (512K) -
R. Yoshida, H. Takada, K. Nakagawa, K. Hioki1995 Volume 48 Issue 4 Pages 325-329
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe occurrence of so-called primary retroperitoneal leiomyoma is rare. In this paper, a case of retroperitoneal leiomyoma accompanying abdominal dull pain is des-cribed. A 66-year-old woman was referred to our hospital because rectal tumor was suspected. Barium enema, CT and MRI revealed a large tumor at the presacral space, and diagnosed as leiomyoma by transrectal needle biopsy. Operation was performed, and a 12.0×11.5×5.8cm retroperitoneal tumor was easily removed. The tumor weighed 305g and was diagnosed histopathologically as benign leiomyoma.View full abstractDownload PDF (3060K) -
S. Mizutani, M. Maruta, Y. Miyajima, J. Kuromizu, T. Utumi, K. Tohyama ...1995 Volume 48 Issue 4 Pages 330-335
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe reported case was a 58-year-old male. The primary focus, rectal cancer was revealed to be type 2 macroscopically at 4.5cm abobe the anal verge. For rectal cancer, abdominoperineal resection was performed. The pathological findings were well differen-tiated adenocarcinoma, a2, ly2, v1, and n0, and surgery was completely curative. Followup of the patient was performed at the outpatient department after surgery. Fourteen months later, CT showed an abnomal shadow at the right adrenal gland. There was no metastasis except in the right adrenal gland. Right side adrenectomy was performed. The histology of the resected adrenal gland was the same as that of rectal carcinoma. The patient survived for 2 years and 7 months after adrenectomy, and died of pulmonary metastasis.View full abstractDownload PDF (4372K) -
H. Kotanagi, Y. Saitoh, Y. Shibata, O. Aizawa, J. Tanaka, K. Koyama1995 Volume 48 Issue 4 Pages 336-339
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 60 year-old woman was admitted for massive anal bleeding. Hemostasis could not be obtained by medical treatment, and anemia progressed. Emergency surgery was performed and bleeding from a polypoid lesion in the cecum was found. A right hemicolectomy was carried out. Microscopic examination of the resected specimen revealed the rupture of an artery of the submucosal layer in the adenoma which contained well differentiated adenocarcinoma. After the surgery, bleeding from the site of skin incision and ileotransverse colostomy occurred. Leukoerythroblastosis, thrombocytopenia and tear-drop cells were found in the peripheral blood. By biopsy of the bone marrow, idiopathic myelofibrosis was diagnosed. Massive bleeding from colonic adenoma is very rare. During surgery, the patient may have bleeding disorders, therefore, transfusion of thrombocytes or blood coagulation factors may be necessary at the time of emergency surgery.View full abstractDownload PDF (4681K) -
H. Aoki, Y. Yoshii, K. Kato, M. Iinuma1995 Volume 48 Issue 4 Pages 340-346
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSTwelve patients that could not tolerate oral lavage solution NIFLEC(R) for colonoscopy were given highly osmotic sodium phosphate solution (NAP). Ten patients (83%) preferred NAP to NIFLEC(R) and no patient preferred NIFLEC(R). Nine patients (75%) given NAP showed adequate cleansing for colonoscopy. In the NAP group, serum total protein values were increased suggesting intravascular volume depletion. The increase of serum sodium values and the decrease of serum potassium values suggested overload of the cardiovascular system. However, plasma HANP values did not reveal any cardiovascular overload. Oral potassium administration by Slow-K(R) compensated for the decrease of serum potassium values after preparation with NAP. It was concluded that NAP is a useful colonic cleansing agent for patients who can not tolerate NIFLEC(R).View full abstractDownload PDF (349K) -
T. Yatsuoka, H. Mochizuki, K. Hase, S. Bekku, K. Yoshimura, T. Yamamot ...1995 Volume 48 Issue 4 Pages 347-352
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSFrom June 1984 to December 1993, local excision by posterior approach was per-formed for 22 anorectal tumors, which were found in 20 cases (11 males and 9 females). Tumor size ranged from 0.7cm to 11.0cm (mean, 3.4cm) and Tumors were located within 2.0cm to 10.0cm (mean, 5.5cm) of the anal verge. Seven tumors were adenomas and the others were carcinomas, in which 14 lesions were at the early stage (m 10 'sm 4) and one invaded to the rectal muscle wall. Thirteen lesions were locally excised by transsacral approach, whereas 9 were excised by trans-sphincteric approach. Digital examination and transanal ultrasonography are very useful for preoperative detection of the depth of tumor invasion, which is essentially important information for choozing the local excision procedure. No one reported any postoperative change in their bowel, bladder and sexual functions. There has been no local recurrence and distant metastasis due to insufficient resection. Local excision by posterior approach seems to be a very useful method for the treatment of anorectal tumors, which are unsuitable for endoscopic local excision only if the indication is carefully observed.View full abstractDownload PDF (396K) -
A. Kakisaka, Y. Yamamoto, K. Kamiya, M. Inagaki, S. Kino, T. Kono1995 Volume 48 Issue 4 Pages 353-359
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSIn lower gastrointestinal tract surgery, an intraintestinal biofragmentable anastomosis ring (BAR) was used to perform anastomosis following bowel resection and assessed the results. Among two patients with colorectal cancer, the one with cancer of the ascending colon was treated by right hemicolectomy and the one with lower rectal cancer (Rb) was treated by low anterior resection. None of the five patients in which the BAR was used at our department, including these two patients, developed stenosis, anastomotic failure, or other complications either intraoperatively or postoperatively, and their course has been favorable so far during follow up. It is particularly noteworthy that the BAR could be used for repair after low anterior resection in the patient with lower rectal cancer without great difficulty.
Thus, considering that manipulation of the BAR is easy and can be performed rapidly, it appears to be an effective method of anastomosis applicable to a wide range of gastrointestinal tract surgeries.View full abstractDownload PDF (6526K) -
Partial Cystectomy and Substitution Cystoplasty for Urinary Bladder Involvement of Colorectal CancerK. Kotake, Y. Koyama, J. Nasu1995 Volume 48 Issue 4 Pages 360-364
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA procedure of partial cystectomy and substitution ileocystoplasty for locally advanced colorectal cancer invading the bladder is described. Eight of the 14 patients who had primary colorectal cancer with bladder involvement underwent partial cystectomy for curative intent. In 6 patients, supratrigonal wide-resection of the bladder and subsequent reconstruction with ileocystoplasty to enlarge the bladder were performed. Urinary functions in terms of bladder capacity, residual urine volume, urinary frequency and continence were satisfactorily preserved in all but one patient who developed urinary fistula postoperatively. Urodynamic study of the reconstructed bladder in 4 patients was carried out, and fairly good function was observed. One patient died of the disease, and one is alive with pelvic recurrence. The remaining 4 are alive with no evidence of disease with a mean survival of 60 months (ranged from 33 to 90 months). In conclusion, this procedure may be a useful technique for preserving normal urinary function in selected patients.View full abstractDownload PDF (1811K) -
1995 Volume 48 Issue 4 Pages 365-379
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (1103K)
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