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Volume 48, Issue 9
Displaying 1-15 of 15 articles from this issue
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K. Aoyagi1995 Volume 48 Issue 9 Pages 979-991
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAs experimental studies on the selection of effective antibacterial agents for preventing postoperative infection following colon surgery, changes in main bacteria composing normal intestinal florae after administration of various antibacterial agents were investigated using rats carrying methicillinresistant Staphylococcus aureus (MRSA), and interactions between bacteria in mixed culture in GAM broth were also observed. In in vivo experiments, MRSA increased in number after concomitant administration of kanamycin and metronidazole and also after single administration of latamoxef while Escherichia coli (E. coli) and Bacteroides spp. decreased in number, whereas no increase in MRSA was observed after single administration of cefotiam (CTM) or metronidazole. In in vitro experiments, MRSA increased in number when the growth of 2 strains, E. coli and Enterococcus faecalis (E. faecalis) or Bacteroides fragilis (B. fragilis), was strongly inhibited simultaneously. These results indicated that the growth of MRSA can be facilitated, if an antibacterial agent that strongly inhibits the growth of E. coli and Bacteroides at the same time is selected. Thus antibacterial agent (s) with antibacterial activity mainly against E. coli, such as CTM, should be selected as a first-choice drug for clinical cases to prevent postoperative infection after colon surgery.View full abstractDownload PDF (837K) -
M. Watanabe, H. Nakazaki, T. Maeda, S. Hanawa, Y. Hasebe, T. Ohoshiro, ...1995 Volume 48 Issue 9 Pages 992-1000
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThis report analyzes experiences with 52 liver resections for metastatic colorectal carcinoma. The One-, 3-and 5-year survival rates were 77.9%, 51.0 % and 39.7%, respectively. With respect to the disease in primary cancer, the presence or absence of 3 or more mesenteric lymph nodal metastases was the predominantly prognostic determinant. With respect to the liver, synchronous liver metastases has poor prognosis deposits and H factor were not a significant determinant of unfavorable prognosis. The survival rates after smaller resections, wider resections or several resections were not essentially identical. However, the survival rate of the patients who received intraarterial chemotherapy was better than those who did not under so that treatment.View full abstractDownload PDF (507K) -
Clinicopathological Studies and Analysis of DNA Ploidy Pattern on Multiple Cancer of the Large BowelK. Nakao, M. Shibusawa, A. Tsunoda, G. Kamiyama, M. Takada, N. Yokoyam ...1995 Volume 48 Issue 9 Pages 1001-1008
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSFrom 1981 to 1992, 49 patients with multiple carcinomas of the large bowel underwent surgery in our department. These 49 patients accounted for 7.5% of the total patients (651) of colorectal cancer. Of the 49 patients, 41 (6.3%) were diagnosed as synchronous multiple colorectal cancer (smcc), while 8 (1.2 %) were diagnosed as metachronous multiple colorectal cancer (mmcc). In smcc, the site of the first and second cancers were predominantly located in the same or adjoining lesions. The incidence of adenoma, family history of cancer, and early stage for the second cancer in patients with smcc was higher than that in patients with single colorectal cancer (scc), respectively. In flow cytometry, incidence of diploidy of the first cancer in smcc was higher, too.
The patients with mmcc were younger at their first operation than those with see, while, at their second operation, they were older than those with scc. Mmcc was predominantly located in the right colon even if that was the first or second. The site of the first cancer in mmcc was different from the segment of the second cancer, except in one patient.
Therefore, second colorectal cancer should be taken into account when examining carcinoma in the large bowel.View full abstractDownload PDF (459K) -
Nerve Preserving Operation for Rectal CancerM. Yamamoto1995 Volume 48 Issue 9 Pages 1009-1016
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDetailed dissections were performed on 20 adult cadavers to examine the surgical anatomy of the pelvic autonomic nerve plexus from a lateral view of the pelvis. The pelvic plexus was situated in the upper part of the peritoneal reflection of Douglas' pouch under the pelvic fascia and averaged 3.5 x 2.2 cm in size. A point of intersection was determined on the tangent line (O-Sn) between the bottom of the sacrum and the pubis, and the line (Sn (O-P)) through the bottom of sacrum, that was drawn parallel to the line (O-P) between the promontrium and the pubis. The upper angle of the pelvic plexus, seen from a lateral view, was located in the anterior area between S1 (O-P) and S2 (O-P). The anterior angle of the pelvic plexus was located in the area surrounded by O-S3, O-S4 and S2 (O-P) in men, and by O-S3, O-S5, S2 (O-P) and S3 (O-P) in women. The 4th pelvic splanchnic nerve (S4n) was traced to the direction of the upper margin of the pubis through the 4th pelvic sacral foramen in men and the lower margin of the pubis in women. It was concluded that if the positional relation between rectal cancer and the pelvic plexus becomes clear, total autonomic nerve preserving operation and S4n preserving operation will be performed precisely.View full abstractDownload PDF (1791K) -
1995 Volume 48 Issue 9 Pages 1017-1025
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSMelanosis coli develops by longterm taking of stimulative laxatives such as senna and aloe, and the organic changes are thought not only to be limited to the mucosa but to spread to the nerveplexus of the intestinal wall which exacerbates constipation. However the pathogenesis or pathophysiologily is not fully yet clarified. Therefore, formation of the experimental animal model is considered to be needed and for the purpose, male guinea pigs are administrated with commercially available sennocot® granules containing anthraquinon. The dose was speculated the adult dose. When the exssesive doses were administrated to guinea pigs, grossly the colon showed black staining, and the histologically deposition of brownish pigmented granules in the submucosa were observed. The pathological chenges of the model were similar to those of the human. The amount of pigment diposition basically depended on or well corelate with the administrated amount, which shows administration of the drug makes melanosis coli. The pigmental deposit occured in the cecum and almost not in the colon and rectum. The melanosis coli thus formed experimentally will be useful to the clarification of the pathogenesis.View full abstractDownload PDF (2846K) -
Y. Tsuji, M. Takano, I. Kubota, F. Tokumine, Y. Kamura, T. Toyohara1995 Volume 48 Issue 9 Pages 1026-1032
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSOf patients, who visited our hospital as outpatient from January to December 1944, 99 patients (50 male and 49 female patients; age ranging from the twenties to the seventies) without anorectal lesions were selected, and their anorectal functions were examined. The results were as follows. 1) There was no significant difference between male and female in the patients from the twenties to the sixties in maximum static pressure of anal canal, maximum voluntary pressure of anal, canal and discharge pressure. However, significant decrease was noted in the patients of both sexes in their seventies compared with the other age groups. 2) Length of functional anal canal was significantly shorter in the twenties in both male and female compared with the other age groups. In the patients from the thirties to the seventies, there was no significant difference between male and female. 3) In rectal sensory threshould, maximum tolerance, and rectal compliance, no significant difference was found between male and female patients in any of the groups examined.
The results suggest that anal functions are more susceptible to the influence of sex and aging than rectal functions and that special care must be taken on the selection of surgical modes by taking sex and aging into account in the surgical operation of anorectal lesions.View full abstractDownload PDF (361K) -
S. Yamanaka1995 Volume 48 Issue 9 Pages 1033-1041
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSQualitative diagnosis of lymph-node (LN) metastasis in colorectal cancer is still unreliable. Therefore, the author developed this diagnosis using intraoperative color doppler flow imaging (CDI) . Since August 1994, CDI has been performed on 105 LNs from 42 colorectal cancer patients. The first 10 cases (29LNs) were examined as a provisional study. 1. The blood flow (BF) pattern inside the LNs was analyzed in a provisional study and diagnostic criteria were set. 2. A prospective study of CDI and B-mode was conducted. 3. CDI images were compared with histopathologic specimens. Results: 1, BF patterns were classified into 4 types. Type I: Bf branched from the hilum to the LN. Type IIa: BF was detected just inside the LN. Type IIb: BF was seen in the LN margin. Type III No BF was detected. Type I was considered negative metastasis and types II and III as positive, 2. CDI/B-mode were ; accuracy (94.7%, 77.6%), sensitivity (96.2%, 73.1%), specificity (94.0%, 80.0%), positive predict value (89.3%, 65.5%), negative predict value (97.9 %, 85.1%), respectively. CDI was superior to B-mode (p<0.05) . 3. Delineated BF repre-sented intratrabecular vessels confirming the BF changed due to the structural change by metastasis. The intraoperative CDI reflects LN's the histological picture and is very useful for quantitative diagnosis of LN metastasis in colorectal cancer.View full abstractDownload PDF (3298K) -
T. Nishihara, Y. Chung, S. Kim, T. Ikehara, M. Okuno, M. Sowa1995 Volume 48 Issue 9 Pages 1042-1046
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe encountered a case of pseudomyxoma peritonei occurring in the ascending colon canser. Pseudomyxoma peritonei arises in association with a ruptured primary mucinous adenocarcinoma, usually, occurring in theappendix and ovary, but rarely from the colon.
A 71-year-old man whose chief complaint was abdominal bulging from 1990 July was admitted to our hospital in October of the same year. At the time of admission, there was retention of ascites in the abdominal region and a mass about a man's-fist size was felt in the right lower abdomen. Barium enema showed Borrmann 1 type lesion in the ascending colon. Computed tomography showed scalloping of the liver at the right subdia-phragma and the dense areas surrounded by the spleen, ascending tumor and Douglas's pauch. Thus the diagnose was pseudomyxoma peritonei occurring in the ascending colon cancer. A laparotomy was performed and revealed a man's-fist size tumor disseminated over the entire peritoneal cavity. This colon tumor was identified histologically as muci-nous carcinoma which had disseminated through the serosa of the colon. we reported a rare case of pseudomyxoma peritonei occurring in the ascending colon canser diagnosed by computed tomography preoperation.View full abstractDownload PDF (3131K) -
T. Ohwan, M. Takano, K. Takagi, N. Fujimoto, R. Nozaki, H. Adaniya1995 Volume 48 Issue 9 Pages 1047-1053
Published: 1995
Released on J-STAGE: December 03, 2009
JOURNAL FREE ACCESSA 53-years-old female ulcerative colitis patient had complained of mucous bloody stools, was treated as a proctitis type 4 years, and was admitted in April 1993. Since her condition resisted intravenous hyperalimentation and intravenous high dose steroid hormone (SH) therapy and progressed to total colitis type, γ-globulin therapy was attempted. After the therapy, clinical symptoms and colonofiberscopic findings improved.
In this patient, the serum IgA level was normal at the initial examination and after discharge, but selective IgA deficiency was noted during hospitalization after administration of high dose SH. Latent immunological disorders are considered to have been present, and transient selective IgA deficiency is also considered to have been induced by high dose SH.View full abstractDownload PDF (2317K) -
T. Fujihara, T. Ikehara, Y. Kato, A. Nitta, K. Maeda, Y. Yamamoto, M. ...1995 Volume 48 Issue 9 Pages 1054-1059
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSMesenteric panniculitis is an unspecific inflammatory disease rarely induced in the mesenterium. A case of mesenteric panniculitis on the colon seen in a 73-year-old man is reported. He was admitted after suffering from lower abdominal pain, anorexia and diarrhea for 3-months.
On physical examination, a mass was palpable in the lower abdomen. Barium enema revealed narrowing of the sigmoid colon with a serrated mucosal surface. Colonoscopy revealed mucosal edema from the rectum to the sigmoid colon, without erosion and tumor. Computed tomography showed inflammation of adipose tissue consisting of diffuse thickened mesentery and well-defined segments of the sigmoid colon. Preoperatively mesenteric panniculitis was diagnosed.
At laparotomy, the lesion appeared as a marked thickening and firm mass of the mesocolon with a puckered surface and rubbery consistency involving appendices epiproi-cae, with multiple reddish-brown discolored foci. He underwent low anterior resection along with sigmoidectomy. Pathological findings were inflammatory involvement of round foamy macrophages, lymphocytes and giant cells in the fibroadipose tissue. The postope-tative course was uneventful.View full abstractDownload PDF (2897K) -
S. Kim, T. Taguchi, M. Izukura, Y. Tanji, E. Shiba, S. Takai, M. Takam ...1995 Volume 48 Issue 9 Pages 1060-1064
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA case of hereditary nonpolyposis colorectal cancer (HNPCC) with appendiceal cancer is reported. A 59-year-old man had had 5 cancers (4 colon cancers, 1 gastric cancer), including synchronous and metachronous cancers, since he was 41 years old. His mother had gastric cancer, and his brother had rectal cancer. He underwent low anterior resection of the rectum for rectal cancer in January 1994. During the operation, another tumor of the appendix was found and considered as mucocele; therefore, appendectomy was performed. Histological examination showed primary adenocarcinoma of the appen-dix, which consisted of mucinous cystadenocarcinoma and well-differenciated adenocarcinoma. HNPCC usually includes carcinomas of the proximal colon. The reported rate of incidence is approximately 70%. However, carcinoma of the appendix had not been reported until our investigation.View full abstractDownload PDF (2213K) -
N. Iwase, M. Oya, T. Yanagida, Y. Hirayasu, Y. Ishii, T. Kubota, J. Ko ...1995 Volume 48 Issue 9 Pages 1065-1069
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSFecal occult blood test (FOBT) may be positive due to anal diseases such as hemorrhoids and anal fissure. However, there has been no detailed study as to the frequency of positive FOBT or the clinical significance of positive FOBT in patients with anal diseases. We have carried out FOBT in 232 patients who visited out-patient clinics complaining of anal symptoms possibly caused by anal diseases. FOBT was positive in 19 patients (8.2%). The positive rate did not differ from than of patients who underwent health screening tests. Four out of 16 patients who had a positive test were found to have colonic cancer by barium emema or colonoscopy. Although 62 patients whose FOBT was negative also underwent these examinations, no colorectal cancer was revealed. Neither the extent of anal prolapse, subjective symptoms, nor objective findings of tendency to bleed correlated with the FOBT positive rate. These results suggest that FOBT is useful in detecting colorectal cancer even if the patients had anal disease, and patients with positive FOBT should undergo detailed examination for colorectal cancer even if they have anal symptoms.View full abstractDownload PDF (311K) -
Y. Ishii, M. Oya, K. Hirose, T. Nakamura, J. Komatsu, Y. Takase, H. Te ...1995 Volume 48 Issue 9 Pages 1070-1075
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAlthough defecography is a valuable diagnostic tool for the assessment of pelvic floor function, the usual method performed in the sitting position on a commode is uncomfortable for patients. We have been taking lateral views of the anorectum at rest; during maximum pelvic floor contraction (during squeeze), and during straining following usual barium enema examination. This simple defecography was carried out on 63 patients (32 males and 31 females with a mean age of 49.7 years) who underwent barium enema examination without having any of anorectal symptoms, left-sided colorectal cancer, inflammatory bowel disease, or history of anorectal operation. Measurable parameters were compared by gender and age. Significantly shorter anal canals and significantly lower pelvic floor positions were found in females than in males during squeeze. The older the patient, the lower the position of the anal verge at rest, during squeeze, and during straining. Anorectal angle at rest was significantly more obtuse in older patients. Rectocele was found in 9 females and 1 male. These results reproduced the results of previous papers reporting the weakness of the pelvic floor musculature in females and in the elderly. Assessment of the pelvic floor function appears possible using this simple defecography.View full abstractDownload PDF (1240K) -
Y. Sakai, H. Nishikawa, K. Nishimura, S. Hisano, K. Miura1995 Volume 48 Issue 9 Pages 1076-1079
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSFiteen patients with local recurrence of the rectal cancer received chemotherapy (3 cases), chemoradiotherapy (5 cases) and hyperthermoradiochemotherapy (7 cases). Although PR was attained in three cases with hyperthermoradiochemotherapy, there was no difference in the effect on the survival among these therapeutic modalities. Radiochemotherapy and hyperthermoradiochemotherapy relieved or reduced the local pain caused by the local recurrence. Hyperthermoradiochemotherapy was effective in pain relief even in the patient who received postoperative radiation therapy.
Metastasis was the main cause of death among the patients who received hyperthermoradiochemotherapy. On the other hand, the local extention of the recurrence was the main cause of death in the other therapy groups. Hyperthermoradiochemotherapy seems to prevent the local extention of recurrent cancer.View full abstractDownload PDF (272K) -
Y. Mori, S. Simizu, M. Nakajima, H. Sugiura, M. Miyaoka, T. Saito1995 Volume 48 Issue 9 Pages 1080-1085
Published: 1995
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe evaluated the usefulness of TMK 777 (TMK, manufactured by Terumo Inc.), an inhibitor of 5-lipoxygenase (a key enzyme involved in leukotriene biosynthesis), using a trinitrobenzene sulphonic acid (TNB) induced rat colitis model.
Colitis was induced in male S-D strain rats (7 weeks old) according to the method discribed by Morris et al., and TMK was administered per anus four hours before the experiment for seven days successively. Only solvent (used for dissolving the drug) was administered to control rats.
Leukotriene (LT) B4 levels were measured successively, and LTB4 levels were significantly lower in the TMK group than in control group on day 3 after inducing colitis and remained low even on day 7 (p<0.05), and significant difference was seen macro-scopically, but no significant difference was seen histrogically.
The results suggest that TMK 777 lowers LTB4 production in rats with TNB induced colitis, inhibiting inflammation and facilitating the healing processes. We speculate that TMK 777 may be useful for the treatment of inflammatory bowel disease.View full abstractDownload PDF (1433K)
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